Individual provider Active NPI

Gabrielle Paige Hackett, PSY.D.

  • Psychologist
  • Vero Beach, FL
National Provider Identifier
1407200645
Registry record updated Jun 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY 9507 Issued in FL
Practice address
1575 Indian River Blvd Ste C225
Vero Beach, FL 32960-7127
Phone
(954) 812-3482
Fax
(954) 900-1197
NPI assigned
Apr 13, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY 9507 FL Primary

Addresses

Primary practice location

1575 Indian River Blvd Ste C225
Vero Beach, FL 32960-7127

Mailing address

18601 Tranquility Base LN
Port St Lucie, FL 34987-3236
Phone (954) 812-3482

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20170719003758 FL Practitioner - Clinical Psychologist 2961779376 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1575 Indian River Blvd
Suite C225
Vero Beach, FL 32960-7127
Phone (954) 812-3482

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY 9507FLMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Gabrielle P. Hackett, Psy.D., LLC CurrentSince Jan 5, 2017 Accepting new patients

Locations

1575 Indian River Blvd
Ste C225
Vero Beach, FL 32960
Phone (954) 812-3482

1705 19th Pl
Ste A1C
Vero Beach, FL 32960

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": "1460505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1407200645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18601 TRANQUILITY BASE LN",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349873236",
            "telephone_number": "954-812-3482",
            "fax_number": "954-900-1197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 INDIAN RIVER BLVD STE C225",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329607127",
            "telephone_number": "954-812-3482",
            "fax_number": "954-900-1197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACKETT",
        "first_name": "GABRIELLE",
        "middle_name": "PAIGE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-13",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY 9507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

Verify at the official NPI Registry.