Individual provider Active NPI

Sean O'Hagen, PH.D.

  • Psychologist
  • Vestal, NY
National Provider Identifier
1407049786
Registry record updated Apr 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
019322 Issued in NY
Practice address
220 Front St
Vestal, NY 13850-1514
Phone
(973) 715-2572
Fax
(607) 238-3043
NPI assigned
Aug 21, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 019322 NY Primary

Addresses

Primary practice location

220 Front St
Vestal, NY 13850-1514

Mailing address

220 Front St
Vestal, NY 13850-1514
Phone (973) 715-2572

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20190318002445 NY Practitioner - Clinical Psychologist 2961742556 Practice locations: Johnson City, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
019322NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Sean O'Hagen, PH.D. Psychology PLLC Psychologist CurrentSince Dec 22, 2019 Accepting new patients

Locations

231 Main St
Lbby Lvl
Vestal, NY 13850
Phone (607) 205-1394

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": "1187654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775520000000",
    "number": "1407049786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 FRONT ST",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138501514",
            "telephone_number": "973-715-2572",
            "fax_number": "607-238-3043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 FRONT ST",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138501514",
            "telephone_number": "973-715-2572",
            "fax_number": "607-238-3043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'HAGEN",
        "first_name": "SEAN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-21",
        "last_updated": "2026-04-07",
        "certification_date": "2026-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "019322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vestal, NY

Sources for this page

Verify at the official NPI Registry.