Kaitlyn Callais Stafford, LCSW OR LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW4261 Issued in HI

Practice address

41-038 Wailea St Ste C
Waimanalo, HI 96795-1671

Phone

(808) 518-4976

NPI assigned

Oct 18, 2016

Last updated

Dec 7, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rising Behavioral Health Consulting, LLC

  • Adult Mental Health Clinic/Center
  • Waimanalo, HI
  • NPI 1184139156
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1476748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512604800000",
    "number": "1225589955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41-038 WAILEA ST STE C",
            "city": "WAIMANALO",
            "state": "HI",
            "postal_code": "967951671",
            "telephone_number": "808-518-4976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41-038 WAILEA ST STE C",
            "city": "WAIMANALO",
            "state": "HI",
            "postal_code": "967951671",
            "telephone_number": "808-518-4976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAFFORD",
        "first_name": "KAITLYN",
        "middle_name": "CALLAIS",
        "credential": "LCSW OR LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-18",
        "last_updated": "2017-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW13674",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "3858C",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "HI",
            "license": "LCSW4261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mari Shimazu
• Elizabeth Raquel Silva-Kaplan
• Shana L Sniffen, M.D.
• Social Context Therapy & Consultation
• Ashley Kamehailani Sonoda, PHARM D
• Nita C Stockwell
• Bernice Strand, LCSW, CSAC, CGP
• Sustain Hawaii
• Ryota Takahara, RBT
• Heather Tesoro

• Clinical Social Worker in Waimanalo, HI
• Providers in Waimanalo, HI by specialty
• Clinical Social Worker in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.