Individual provider Active NPI

Terilynn Uilani Raquedan, MFT

  • Marriage & Family Therapist
  • Honolulu, HI
National Provider Identifier
1780144824
Registry record updated Nov 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
505 Issued in HI
Practice address
1221 Kapiolani Blvd Ste 248
Honolulu, HI 96814-3506
Phone
(707) 514-5963
NPI assigned
Mar 24, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 505 HI Primary

Addresses

Primary practice location

1221 Kapiolani Blvd Ste 248
Honolulu, HI 96814-3506

Mailing address

95-708 Makaiolani St
Mililani, HI 96789-2940
Phone (808) 707-6378

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

LicenseStateTypeSpecialty
505HIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Grace in Life LLC Marriage & Family Therapist CurrentSince Nov 9, 2021 Accepting new patients

Locations

1221 Kapiolani Blvd
Ste 248
Honolulu, HI 96814
Phone (808) 372-1787

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1553385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635897600000",
    "number": "1780144824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95-708 MAKAIOLANI ST",
            "city": "MILILANI",
            "state": "HI",
            "postal_code": "967892940",
            "telephone_number": "808-707-6378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 KAPIOLANI BLVD STE 248",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968143506",
            "telephone_number": "707-514-5963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAQUEDAN",
        "first_name": "TERILYNN",
        "middle_name": "UILANI",
        "name_prefix": "Ms.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-24",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "HI",
            "license": "505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.

Verify at the official NPI Registry.