Provider Demographics
NPI:1609425248
Name:SEAN O'HAGEN, PH.D. PSYCHOLOGY PLLC
Entity Type:Organization
Organization Name:SEAN O'HAGEN, PH.D. PSYCHOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLGOIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:OHAGEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:607-205-1394
Mailing Address - Street 1:231 MAIN ST LBBY LVL
Mailing Address - Street 2:
Mailing Address - City:VESTAL
Mailing Address - State:NY
Mailing Address - Zip Code:13850-1548
Mailing Address - Country:US
Mailing Address - Phone:607-205-1394
Mailing Address - Fax:607-238-3749
Practice Address - Street 1:231 MAIN ST LBBY LVL
Practice Address - Street 2:
Practice Address - City:VESTAL
Practice Address - State:NY
Practice Address - Zip Code:13850-1548
Practice Address - Country:US
Practice Address - Phone:607-205-1394
Practice Address - Fax:607-238-3749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-06
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty