Lighthouse Therapy & Diagnostic Services - Medicare Mental Health Clinic in Kilauea, HI

Lighthouse Therapy & Diagnostic Services is a medicare enrolled mental health clinic (Psychologist - Clinical) in Kilauea, Hawaii. The current practice location for Lighthouse Therapy & Diagnostic Services is 2509 Kolo Road, Kilauea, Hawaii. For appointments, you can reach them via phone at (808) 652-0466. The mailing address for Lighthouse Therapy & Diagnostic Services is 5108 Kuhina Pl, Princeville, Hawaii and phone number is (808) 652-0466.

Lighthouse Therapy & Diagnostic Services is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1710511100. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (808) 652-0466.

Contact Information

Lighthouse Therapy & Diagnostic Services
2509 Kolo Road
Kilauea
HI 96754
(808) 652-0466
Not Available

Mental Health Clinic Profile

Full NameLighthouse Therapy & Diagnostic Services
SpecialityPsychologist
Location2509 Kolo Road, Kilauea, Hawaii
Authorized Official Name and PositionShelly Ludolph (CLINICAL PSYCHOLOGIST)
Authorized Official Contact8086520466
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Lighthouse Therapy & Diagnostic Services
5108 Kuhina Pl
Princeville
HI 96722-5116

Ph: (808) 652-0466
Lighthouse Therapy & Diagnostic Services
2509 Kolo Road
Kilauea
HI 96754

Ph: (808) 652-0466

NPI Details:

NPI Number1710511100
Provider Enumeration Date02/25/2020
Last Update Date02/25/2020
Certification Date02/25/2020

Medicare PECOS Information:

Medicare PECOS PAC ID9133559248
Medicare Enrollment IDO20200413002896

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Medical Identifiers

Medical identifiers for Lighthouse Therapy & Diagnostic Services such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1710511100NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103TC0700XPsychologist - Clinical (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Lighthouse Therapy & Diagnostic Services acts as a billing entity for following providers:
Provider NameShelly Ludolph
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1346784147
PECOS PAC ID: 0042640153
Enrollment ID: I20200413003053

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Psychologist in Kilauea, HI

Larisa Nebre, Llc
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Medicare: Not Enrolled in Medicare
Practice Location: 4343 Aalona St, Kilauea, HI 96754
Phone: 808-635-2114    
Common Chord Psychology Services, Inc
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Medicare: Not Enrolled in Medicare
Practice Location: 2325 Liliuokalani St, Kilauea, HI 96754
Phone: 808-639-1404    
Mindful Healing Counseling Llc
Mental Health Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 4166 Momi St, Kilauea, HI 96754
Phone: 808-635-4371    
Positive Support Services, Llc
Mental Health Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 1611 Huli Rd, Kilauea, HI 96754
Phone: 808-292-7968    
Seaside Psychological Services, Inc.
Mental Health Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 2330 Kolo Road, Kilauea, HI 96754
Phone: 808-639-1404    
Chie Takahashi, Lcsw, Llc
Mental Health Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 6751m Koolau Road, Kilauea, HI 96754
Phone: 808-450-8828    

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