LIGHTHOUSE THERAPY & DIAGNOSTIC SERVICES
NPI 1710511100
Psychologist - Clinical in Kilauea, HI

Q: What is Lighthouse Therapy & Diagnostic Services's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Active since February 25, 2020

2509 KOLO ROAD, KILAUEA, HI 96754(808) 652-0466 Get Directions Write a Review

NPPES record last updated: February 25, 2020. Verified against the NPPES registry weekly; last sync: November 01, 2026.

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About Lighthouse Therapy & Diagnostic Services NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LIGHTHOUSE THERAPY & DIAGNOSTIC SERVICES (NPI 1710511100) is a healthcare organization registered as a clinical in Kilauea, Hawaii and active in the NPI registry since February 2020. The organization lists Shelly Ludolph, Clinical Psychologist, as its authorized official.

NPPES Registry Identity

NPI1710511100

Entity TypeOrganization

Primary Taxonomy103TC0700X

Legal Business NameLIGHTHOUSE THERAPY & DIAGNOSTIC SERVICES

Location Address2509 KOLO ROADKilauea, HI 96754

Mailing Address5108 Kuhina PlPrinceville, HI 96722-5116 · (808) 652-0466

Phone(808) 652-0466

Organization SubpartNo

Authorized OfficialShelly LudolphClinical Psychologist · (808) 652-0466

Enumeration DateFebruary 25, 2020

✔ NPI 1710511100 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

2509 KOLO ROAD, Kilauea, HI 96754

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Other Names 1

Other NameShelly Ludolph

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lighthouse Therapy & Diagnostic Services is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Lighthouse Therapy & Diagnostic Services, which bills Medicare for the services this clinician delivers.

Clinician (1)

Shelly Ludolph, PSYD

Clinical Psychologist

NPI 1346784147

3-3122 KUHIO HWY STE A15
Lihue, HI 96766

(808) 246-9102

✔ PECOS✔ Accepts Medicare16 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lighthouse Therapy & Diagnostic Services's NPI number?

The NPI number for Lighthouse Therapy & Diagnostic Services is 1710511100. It was assigned to this organization in the NPPES registry on February 25, 2020. The provider is also known as Shelly Ludolph.

Where is Lighthouse Therapy & Diagnostic Services located?

Lighthouse Therapy & Diagnostic Services is located at 2509 Kolo Road, Kilauea, HI 96754. The listed phone number is (808) 652-0466.

What is Lighthouse Therapy & Diagnostic Services's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Lighthouse Therapy & Diagnostic Services enrolled in Medicare?

Yes. Lighthouse Therapy & Diagnostic Services is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Lighthouse Therapy & Diagnostic Services?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to Lighthouse Therapy & Diagnostic Services. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Lighthouse Therapy & Diagnostic Services was last updated on February 25, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.