Michael M. Haderlie, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

8097827-2501 Issued in UT

Practice address

233 S. Pleasant Grove Blvd
Suite 203
Pleasant Grove, UT 84062

Phone

(801) 785-4622

Fax

(801) 785-4623

NPI assigned

Sep 13, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Mountain Ridge Behavioral Health Center

  • Clinical Psychologist
  • Mapleton, UT
  • NPI 1902626153
  NPD
• Giles, Haderlie & Associates Family Psychology

  • Family Psychologist
  • Springville, UT
  • NPI 1235501404
  NPD (past)
• GN Giles Group LLC

  • Psychologist
  • Pleasant Grove, UT
  • NPI 1427205764
  NPD (past)

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

{
    "created_epoch": "1379030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379030400000",
    "number": "1013342690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 S. PLEASANT GROVE BLVD",
            "address_2": "SUITE 203",
            "city": "PLEASANT GROVE",
            "state": "UT",
            "postal_code": "84062",
            "telephone_number": "801-785-4622",
            "fax_number": "801-785-4623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 S. PLEASANT GROVE BLVD",
            "address_2": "SUITE 203",
            "city": "PLEASANT GROVE",
            "state": "UT",
            "postal_code": "84062",
            "telephone_number": "801-785-4622",
            "fax_number": "801-785-4623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADERLIE",
        "first_name": "MICHAEL",
        "middle_name": "M.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-13",
        "last_updated": "2013-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "UT",
            "license": "8097827-2501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tailai Guan
• Susan Denise Gunnell, APRN
• Gunnison Valley Hospital
• Chloe Gurr
• Shawn Elizabeth Gurtcheff, MD
• Jay Hafen, LCMHC
• Macy Morgan Hales, RDN
• Elizabeth Kay Hall
• Clark H. Hammond, PH.D., LMFT
• Lisa Handley, LMT, MMP

• All providers in Pleasant Grove, UT
• Psychologist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2013; 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.