MEDICARE: LIGHTHOUSE THERAPY OAHU LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1073446274
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIGHTHOUSE THERAPY OAHU LLC

Provider Business Mailing Address
First Line	:	91-1510 KAIKOHOLA ST
Second Line	:
City	:	EWA BEACH
State	:	HI
Zip	:	96706-6286
Country	:	US
Telephone Number	:	978-238-6346
Fax Number	:

Provider Business Practice Location Address
First Line	:	91-1510 KAIKOHOLA ST
Second Line	:
City	:	EWA BEACH
State	:	HI
Zip	:	96706-6286
Country	:	US
Telephone Number	:	978-238-6346
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	KATHERINE KEKEISEN
Credential	:	LCSW
Telephone Number	:	978-500-4786

Provider Enumeration Date	:	06/05/2026
Last Update Date	:	06/05/2026

Similar Medicare Providers

1235347766 — MS. DENISE D BEITEL L.M.T.
Practice Location Address:

170 S YONGE ST , STE. A
ORMOND BEACH, FL
32174-6286

Practice Phone: 386-673-0524
Practice Fax: 386-673-0539

1063663722 — DR. ATHAS NICHOLAS KOMETAS DMD
Practice Location Address:

3162 S ATLANTIC AVE , SUITE C
DAYTONA BEACH SHORES, FL
32118-6286

Practice Phone: 386-760-0030
Practice Fax: 386-788-3873

1386062743 — PAIN FREE, P.C.
Practice Location Address:

6286 BEACH BLVD
BUENA PARK, CA
90621-2351

Practice Phone: 714-736-0075
Practice Fax: 714-736-0076

1447613013 — PINE TREE ACUPUNCTURE, INC.
Practice Location Address:

6286 BEACH BLVD
BUENA PARK, CA
90621-2351

Practice Phone: 714-333-8363
Practice Fax:

1477112746 — AYNOLI ABREU DELGADO
Practice Location Address:

6286 TENOR DR
WEST PALM BEACH, FL
33413-5700

Practice Phone: 305-979-8078
Practice Fax:

1366374621 — ALEXANDINE GERVAIS
Practice Location Address:

91-2067 KAIOLI ST EWA BEACH
EWA BEACH, HI
96706

Practice Phone: 954-497-0467
Practice Fax:

Directions to “LIGHTHOUSE THERAPY OAHU LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.