Nicole Dorio Hardenburgh, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

025392-01 Issued in NY

Practice address

USA Meddac
11050 Mt. Belvedere Blvd.
Fort Drum, NY 13602

Phone

(315) 772-6184

NPI assigned

Oct 20, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Nicole Bethany Dorio Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1603152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1194324343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "USA MEDDAC",
            "address_2": "11050 MOUNT BELVEDERE BLVD.",
            "city": "FORT DRUM",
            "state": "NY",
            "postal_code": "13602",
            "telephone_number": "315-772-6184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "USA MEDDAC",
            "address_2": "11050 MT. BELVEDERE BLVD.",
            "city": "FORT DRUM",
            "state": "NY",
            "postal_code": "13602",
            "telephone_number": "315-772-6184"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "155 Park Dr",
            "address_purpose": "LOCATION",
            "city": "Saint Robert",
            "state": "MO",
            "postal_code": "655847860",
            "country_code": "US",
            "telephone_number": "844-853-8937",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1450 E 10th St",
            "address_purpose": "LOCATION",
            "city": "Rolla",
            "state": "MO",
            "postal_code": "654013648",
            "country_code": "US",
            "telephone_number": "888-403-1071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARDENBURGH",
        "first_name": "NICOLE",
        "middle_name": "DORIO",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-20",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MO",
            "license": "2020029140",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "025392-01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "490089658",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHD",
            "identifier": "824000481",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "DORIO",
            "middle_name": "BETHANY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kathleen Therese Hanchek, RN,MSN, CNS
• Lisa M Handy, LCSW
• Richard Zachary Haney, DO
• Joel William Hanna, P.T.
• Stephen M. Hanna, RPA-C
• Chelsea Elizabeth Harris, D.M.D.
• Mark Anthony Harris, DENTAL ASSISTANT
• Catherine L Harruff, LPCC
• Jeffrey Glen Hart, PA-C
• Sarah D Hasko, MSN, FNP-C

• Clinical Psychologist in Fort Drum, NY
• Providers in Fort Drum, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2025; 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.