Individual provider Active NPI

Bethanne Kapansky Wright, PSY.D.

  • Clinical Psychologist
  • Kilauea, HI
National Provider Identifier
1629151451
Registry record updated Apr 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
556 Issued in AK
Practice address
2538 Titcomb St
Kilauea, HI 96754-5226
Phone
(808) 346-1674
NPI assigned
Oct 23, 2006
Last updated
Apr 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1724 HI
Clinical Psychologist 103TC0700X 556 AK Primary

Addresses

Primary practice location

2538 Titcomb St
Kilauea, HI 96754-5226

Mailing address

PO Box 1216
Kilauea, HI 96754-1216
Phone (808) 346-1674

Other identifiers 2

IdentifierTypeStateIssuer
556OtherAKPSYCHOLOGIST LICENSE #
1724OtherHIPSYCHOLOGIST LICENSE #

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240619001120 HI Practitioner - Clinical Psychologist 1153620356 Practice locations: Kilauea, HI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2538 Titcomb St
Suite B
Kilauea, HI 96754-5226
Phone (808) 346-1674

PO Box
Suite 1216
Kilauea, HI 96754

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
556AKMDProfessional Counselor
1724HIMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650844800000",
    "number": "1629151451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1216",
            "city": "KILAUEA",
            "state": "HI",
            "postal_code": "967541216",
            "telephone_number": "808-346-1674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2538 TITCOMB ST",
            "city": "KILAUEA",
            "state": "HI",
            "postal_code": "967545226",
            "telephone_number": "808-346-1674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAPANSKY WRIGHT",
        "first_name": "BETHANNE",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2022-04-25",
        "certification_date": "2022-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "HI",
            "license": "1724",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AK",
            "license": "556",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYCHOLOGIST LICENSE #",
            "identifier": "556",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYCHOLOGIST LICENSE #",
            "identifier": "1724",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kilauea, HI

Sources for this page

Verify at the official NPI Registry.