Provider Demographics
NPI:1306937818
Name:GAEBEL, CHERYL LEE (PSYD)
Entity type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:LEE
Last Name:GAEBEL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6477
Mailing Address - Street 2:
Mailing Address - City:KAMUELA
Mailing Address - State:HI
Mailing Address - Zip Code:96743-6477
Mailing Address - Country:US
Mailing Address - Phone:808-885-9668
Mailing Address - Fax:808-885-8549
Practice Address - Street 1:65-1231 OPELO RD
Practice Address - Street 2:KALA COTTAGE #4
Practice Address - City:KAMUELA
Practice Address - State:HI
Practice Address - Zip Code:96743-8376
Practice Address - Country:US
Practice Address - Phone:808-885-9668
Practice Address - Fax:808-885-8549
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY-402103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI192853/01Medicare UPIN
HI0000TDBSNMedicare ID - Type Unspecified
HI87426086-01Medicare UPIN
HIB6566-0Medicare UPIN