Provider Demographics
NPI:1174154025
Name:INOCELDA, DOMINIC KIHANO (LCSW)
Entity type:Individual
Prefix:MR
First Name:DOMINIC
Middle Name:KIHANO
Last Name:INOCELDA
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:MR
Other - First Name:DOMINIC
Other - Middle Name:KIHANO
Other - Last Name:INOCELDA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:94-1004 UKEE PL
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-4241
Mailing Address - Country:US
Mailing Address - Phone:808-554-1006
Mailing Address - Fax:
Practice Address - Street 1:94-1004 UKEE PL
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-4241
Practice Address - Country:US
Practice Address - Phone:808-554-1006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-29
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI3497104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty