Active NPI
Lore S Hannes, PH.D.
- Clinical Psychologist
- Cornwall, NY
National Provider Identifier
1497099493
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 019733
- Practice address
- 21 Laurel Ave
Suite 290
Cornwall, NY 12518-1469 - Phone
- (845) 458-4558
- NPI assigned
- Nov 15, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 019733 | NY | Primary |
Addresses
Primary practice location
21 Laurel Ave
Suite 290
Cornwall, NY 12518-1469
Mailing address
21 Laurel Ave
Suite 290
Cornwall, NY 12518-1469
Phone (845) 458-4558
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019733 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1352937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352937600000",
"number": "1497099493",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 LAUREL AVE",
"address_2": "SUITE 290",
"city": "CORNWALL",
"state": "NY",
"postal_code": "125181469",
"telephone_number": "845-458-4558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21 LAUREL AVE",
"address_2": "SUITE 290",
"city": "CORNWALL",
"state": "NY",
"postal_code": "125181469",
"telephone_number": "845-458-4558"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANNES",
"first_name": "LORE",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-11-15",
"last_updated": "2012-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "019733",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cornwall, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.