Provider Demographics
NPI:1740326867
Name:HADLEY, DON JAMES (PHD)
Entity type:Individual
Prefix:MR
First Name:DON
Middle Name:JAMES
Last Name:HADLEY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20793 FARMINGTON RD
Mailing Address - Street 2:STE 12
Mailing Address - City:FARMINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:48336-3134
Mailing Address - Country:US
Mailing Address - Phone:248-477-5200
Mailing Address - Fax:
Practice Address - Street 1:20793 FARMINGTON RD
Practice Address - Street 2:STE 12
Practice Address - City:FARMINGTON
Practice Address - State:MI
Practice Address - Zip Code:48336-3134
Practice Address - Country:US
Practice Address - Phone:248-477-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301000845103TC0700X, 103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI68OF34626OtherBLUE CROSS BLUE SHIELD
005382218846OtherGM CARELINE CIGNA
ON 43360Medicare ID - Type Unspecified