Laura Sprague Anderson, PSYD

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

PSY 680 Issued in HI

Practice address

4-1435 Kuhio Hwy
Suite 201
Kapaa, HI 96746-1745

Phone

(808) 639-1404

Fax

(808) 822-4412

NPI assigned

Mar 5, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Laura Sprague Anderson-Klontz Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 1, 2018 through Oct 1, 2026

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Common Chord Psychology Services, Inc

  • Mental Health Counselor
  • Kilauea, HI
  • NPI 1063021145
  NPD Authorized official
• Seaside Psychological Services, Inc.

  • Community/Behavioral Health Agency
  • Kilauea, HI
  • NPI 1881860450
  NPD (past) Authorized official

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

{
    "created_epoch": "1362441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362441600000",
    "number": "1134460926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1237",
            "city": "KILAUEA",
            "state": "HI",
            "postal_code": "967541237",
            "telephone_number": "808-639-1404",
            "fax_number": "808-822-4412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4-1435 KUHIO HWY",
            "address_2": "SUITE 201",
            "city": "KAPAA",
            "state": "HI",
            "postal_code": "967461745",
            "telephone_number": "808-639-1404",
            "fax_number": "808-822-4412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "LAURA",
        "middle_name": "SPRAGUE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-05",
        "last_updated": "2013-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "HI",
            "license": "PSY 680",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "HI",
            "license": "PSY 680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "ANDERSON-KLONTZ",
            "middle_name": "SPRAGUE",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Aina Care, LLC
• Alf Enterprises Inc
• C. Latifa Amdur, LIC. AC.
• Amy Norton LLC
• Anita K Anderson, LSW
• Natasha E Andresen, OTR/L
• Christopher Ang
• Anne Dorre, PHD, LLC
• Amanda A Antonino, O.D.
• Mieko Aoki, LM

• Clinical Child & Adolescent Psychologist in Kapaa, HI
• Providers in Kapaa, HI by specialty
• Clinical Child & Adolescent Psychologist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.