Individual provider Active NPI

Judith C. White, PSY.D.

  • Clinical Psychologist
  • Kapaa, HI
National Provider Identifier
1801973391
Registry record updated Oct 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
665 Issued in HI
Practice address
4-885 Kuhio Hwy # a-1
Kapaa, HI 96746-2702
Phone
(808) 346-5859
Fax
(808) 822-5454
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 665 HI Primary

Addresses

Primary practice location

4-885 Kuhio Hwy # a-1
Kapaa, HI 96746-2702

Mailing address

PO Box 1719
Kapaa, HI 96746-5719
Phone (808) 346-5859

Other identifiers 1

IdentifierTypeStateIssuer
23906-1OtherHIHMSA PROVIDER NUMBER

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
I20131024000013 HI Practitioner - Clinical Psychologist 9638304835 Practice locations: Kapaa, HI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4-885 Kuhio Hwy A1
Kapaa, HI 96746-2702
Phone (808) 346-5859

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
665HIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Kauai Integrative Therapies CurrentSince Sep 11, 2014 Accepting new patients

Locations

4-885 Kuhio Hwy
#A1
Kapaa, HI 96746
Phone (808) 346-5859

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349913600000",
    "number": "1801973391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1719",
            "city": "KAPAA",
            "state": "HI",
            "postal_code": "967465719",
            "telephone_number": "808-346-5859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4-885 KUHIO HWY # A-1",
            "city": "KAPAA",
            "state": "HI",
            "postal_code": "967462702",
            "telephone_number": "808-346-5859",
            "fax_number": "808-822-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "JUDITH",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2012-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "HI",
            "license": "665",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA PROVIDER NUMBER",
            "identifier": "23906-1",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kapaa, HI

Sources for this page

Verify at the official NPI Registry.