Provider Demographics
NPI:1902622657
Name:CHIODO, STEPHEN JOSEPH
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:JOSEPH
Last Name:CHIODO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 HUALANI ST APT 372
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-6413
Mailing Address - Country:US
Mailing Address - Phone:412-335-8270
Mailing Address - Fax:
Practice Address - Street 1:80 PAUAHI ST STE 208
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-3044
Practice Address - Country:US
Practice Address - Phone:808-969-1935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-26
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty