Provider Demographics
NPI:1568206712
Name:HADLEY JAGOE COUNSELING
Entity type:Organization
Organization Name:HADLEY JAGOE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPCC
Authorized Official - Prefix:
Authorized Official - First Name:HADLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:JAGOE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-612-0223
Mailing Address - Street 1:2480 KRAUSS CT
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42301-6777
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:201 W 4TH ST
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-4134
Practice Address - Country:US
Practice Address - Phone:870-612-0223
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-22
Last Update Date:2024-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty