Lauren Elaine Ampolos, PHD
Individual provider Active NPI Clinical Psychologist · Kahului, HI
NPI 1013392364 · NPPES record last updated Jul 28, 2015
Key facts
- NPI
- 1013392364
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- PSY-1555 (HI)
- Practice address
- 415 Dairy Rd Ste E-323
Kahului, HI 96732-2348 - Phone
- (808) 518-1619
- NPI assigned
- Jul 28, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
- Opted out of Medicare
- Yes, effective Jan 12, 2026 through Jan 12, 2028
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY-1555 | HI | MD | Health Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Illuminate Wellness | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Psychologist | 103TH0004X | PSY-1555 | HI | |
| Group Psychotherapy Psychologist | 103TP2701X | PSY-1555 | HI | |
| Cognitive & Behavioral Psychologist | 103TB0200X | PSY-1555 | HI | |
| Clinical Psychologist | 103TC0700X | PSY-1555 | HI | Yes |
Addresses
Primary practice location
415 Dairy Rd Ste E-323
Kahului, HI 96732-2348
Mailing address
415 Dairy Rd Ste E-323
Kahului, HI 96732-2348
Phone (808) 518-1619
Other providers in Kahului, HI
- Americare Hawaii, Incorporated
- Americare Hawaii, Incorporated
- Americare Hawaii, LLC
- Anna W Amigo
- Stacy Renee Ammerman
- Anamcara Care Hawaii Inc
- Anamcara Care Hawaii Inc
- Kathleen A Ancheta
- Anderson Chiropractic, LLC
- Amy Anderson
All providers in Kahului, HI · Clinical Psychologist in Hawaii
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 28, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.