Shelly Ludolph, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1828 Issued in HI

Practice address

3-3122 Kuhio Hwy Ste A15
Lihue, HI 96766-1157

Phone

(808) 246-9102

Fax

(808) 246-8609

NPI assigned

Dec 13, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in HI

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.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Lighthouse Therapy & Diagnostic Services

  • Clinical Psychologist
  • Kilauea, HI
  • NPI 1710511100

  Clinical, HI

  Medicare reassignment NPD Authorized official
• Dr Susan Hall Inc

  • Psychologist
  • Kapaa, HI
  • NPI 1093840894
  NPD (past)
• Pacific Clinic, Inc.

  • Psychologist
  • Kapaa, HI
  • NPI 1598965253
  NPD (past)

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

{
    "created_epoch": "1481587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579651200000",
    "number": "1346784147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5108 KUHINA PL",
            "city": "PRINCEVILLE",
            "state": "HI",
            "postal_code": "967225116",
            "telephone_number": "808-652-0466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3-3122 KUHIO HWY STE A15",
            "city": "LIHUE",
            "state": "HI",
            "postal_code": "967661157",
            "telephone_number": "808-246-9102",
            "fax_number": "808-246-8609"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4566 Ohia St",
            "address_purpose": "LOCATION",
            "city": "Kapaa",
            "state": "HI",
            "postal_code": "967461646",
            "country_code": "US",
            "telephone_number": "808-822-5881",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUDOLPH",
        "first_name": "SHELLY",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-13",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "HI",
            "license": "1828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Lorenz
• Amithea Love, PSY.D.
• Denise Love
• Kevin Patrick Lowry
• Emily Bennett Lucente, APRN NP-C
• Jason Luke, D.P.T.
• Cheryl Ann Lum, MSW, LSW
• Jack Lundgren, DDS
• Cristina Irma Lupini
• Orie Lutwin

• Clinical Psychologist in Lihue, HI
• Providers in Lihue, HI by specialty
• Clinical Psychologist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.