LIGHTHOUSE THERAPY & DIAGNOSTIC SERVICES (NPI# 1710511100) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710511100 |
| Entity Type | Organization |
| Organization Name | LIGHTHOUSE THERAPY & DIAGNOSTIC SERVICES |
| Practice Address |
2509 Kolo Road Kilauea HI 96754 |
| Mailing Address |
5108 Kuhina Pl Princeville HI 96722-5116 |
| Practice Telephone | 8086520466 |
| Mailing Telephone | 8086520466 |
| Enumeration Date | 2020-02-25 |
| Last Update Date | 2020-02-25 |
| Authorized Official Name | SHELLY LUDOLPH (CLINICAL PSYCHOLOGIST) |
| Authorized Official Telephone | 8086520466 |
| Authorized Official Credential | PSYD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Shelly Ludolph | Other Name - Individual/Organization |
| Street Address |
2509 KOLO ROAD |
| City | KILAUEA |
| State | HI |
| Zip Code | 96754 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679070403 | Tyler Yamauchi Rautmann | Massage Therapist | 7729 Koolau Rd, Kilauea, HI 96754 | 2018-04-09 |
| 1871035303 | Asher Lyman | Behavioral Analyst | 4141 Kilauea Rd, Kilauea, HI 96754 | 2016-11-15 |
| 1891142980 | Harley Kauai Makani Ness | Contractor | 4325 Ioela Pl, Kilauea, HI 96754 | 2016-05-18 |
| 1699025924 | Jeffrey Curtis Goodman | Family Medicine | 5454 Kahiliholo Road, Kilauea, HI 96754 | 2012-09-13 |
| 1699065599 | The Scott Recovery Retreat | Substance Abuse Rehabilitation Facility | 4030 Pali Moana Place, Kilauea, HI 96754 | 2011-04-12 |
| 1356586614 | Dana Louise Ross | Contractor | 4440 Hookui Road, #7a, Kilauea, HI 96754 | 2008-12-15 |
| 1518008333 | Steven Hillary Backinoff | Physical Therapist | 2207 Io'ela Street, Ste A, Kilauea, HI 96754 | 2007-02-12 |
| 1174617666 | Arnold I. Serota | Surgery | 4801 Wailapa Rd, Kilauea, HI 96754 | 2006-10-02 |
| 1215188271 | Penny Leilani Ornellas | Massage Therapist | 4270 Kilauea Rd, Kilauea, HI 96754 | 2008-10-08 |
| 1518137660 | Dr Gerald J Felcher | Chiropractor | 4270 Kilauea Rd, Suite I, Kilauea, HI 96754 | 2008-03-05 |
| Find all providers in zip 96754 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992319008 | Rachel Huxel | Psychologist | 1821 Keeaumoku St Apt 201, Honolulu, HI 96822-3005 | 2020-09-04 |
| 1386256626 | Gabriela Cretu Cretu | Psychologist | 3820 Pukalani Pl, Honolulu, HI 96816-3816 | 2020-08-18 |
| 1811512635 | Waves of Insight, LLC | Psychologist | 98-402 Koauka Loop Apt 1404, Aiea, HI 96701-4573 | 2020-06-09 |
| 1811546435 | Tami Babino | Psychologist | 95-1249 Meheula Pkwy Ste 195, Mililani, HI 96789-1791 | 2019-09-06 |
| 1477119899 | Patrick Akira Jichaku | Psychologist | 58-129 Wehiwa Way, Haleiwa, HI 96712-9757 | 2019-05-10 |
| 1427513563 | Hannah Im | Psychologist | 377 Keahole St Ste 210, Honolulu, HI 96825-3405 | 2019-02-03 |
| 1427521897 | Amithea Love | Psychologist | 2037 Puu Kaa St, Kapaa, HI 96746-2339 | 2019-01-08 |
| 1699244509 | Jon Joseph Cisneros | Psychologist | 333 Sixth St, Lanai City, HI 96763 | 2018-11-20 |
| 1447729629 | Caitlin J. Tyrrell | Psychologist | 47-668 Hui Kelu St Apt 5, Kaneohe, HI 96744-4626 | 2018-11-17 |
| 1407339344 | Dhira Dibiase | Psychologist | 341 Hualani St, Kailua, HI 96734-2202 | 2018-09-06 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.