Active NPI
Judith Christine Waitley, LMHC
- Mental Health Counselor
- Kailua Kona, HI
National Provider Identifier
1508346586
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MHC-757
- Practice address
- 73-1221 Ahikawa St Unit a
Kailua Kona, HI 96740-9412 - Phone
- (808) 765-5951
- NPI assigned
- Aug 18, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MHC-757 | HI | Primary |
Addresses
Primary practice location
73-1221 Ahikawa St Unit a
Kailua Kona, HI 96740-9412
Mailing address
73-1221 Ahikawa St Unit a
Kailua Kona, HI 96740-9412
Phone (808) 765-5951
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MHC-757 | Other | HI | HAWAII MENTAL HEALTH COUNSELOR LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MHC-757 | HI | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534550400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615334400000",
"number": "1508346586",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "73-1221 AHIKAWA ST UNIT A",
"city": "KAILUA KONA",
"state": "HI",
"postal_code": "967409412",
"telephone_number": "808-765-5951"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "73-1221 AHIKAWA ST UNIT A",
"city": "KAILUA KONA",
"state": "HI",
"postal_code": "967409412",
"telephone_number": "808-765-5951"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAITLEY",
"first_name": "JUDITH",
"middle_name": "CHRISTINE",
"credential": "LMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-08-18",
"last_updated": "2021-03-10",
"certification_date": "2021-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "HI",
"license": "MHC-757",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HAWAII MENTAL HEALTH COUNSELOR LICENSE",
"identifier": "MHC-757",
"state": "HI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kailua Kona, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.