Jacob Edward Hadden, PH.D.
Individual provider Active NPI Clinical Psychologist · Lake Placid, NY
NPI 1336496983 · NPPES record last updated Sep 18, 2014
Key facts
- NPI
- 1336496983
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 016726-1 (NY)
- Practice address
- 2038 Saranac Ave
Lake Placid, NY 12946-1177 - Phone
- (518) 588-5173
- Fax
- (845) 205-4454
- NPI assigned
- Aug 13, 2012
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 048.0092013 | VT | MD | Clinical Psychologist |
| 016726-1 | NY | MD | Pediatric Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 016726-1 | NY | Yes |
| Clinical Psychologist | 103TC0700X | 048.0092013 | VT |
Addresses
Primary practice location
2038 Saranac Ave
Lake Placid, NY 12946-1177
Mailing address
PO Box 1202
Lake Placid, NY 12946-5202
Phone (518) 588-5173
Other providers in Lake Placid, NY
- Amy Garrison
- David Michael Garrison
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- Caitlin Gregg
- Christina Anne Haberek-Windhorse
- Mahmoud I Hamza
- Raymond J Havlicek
- High Peaks Chiropractic Wellness
- High Peaks Chiropractic, LLC
- High Peaks Dental Professional Partnership
All providers in Lake Placid, NY · Clinical Psychologist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 18, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.