Provider Demographics
NPI:1144082512
Name:JAGOE, HADLEY (LPCC)
Entity type:Individual
Prefix:MISS
First Name:HADLEY
Middle Name:
Last Name:JAGOE
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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:870-612-0223
Mailing Address - Fax:
Practice Address - Street 1:2480 KRAUSS CT
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42301-6777
Practice Address - Country:US
Practice Address - Phone:270-869-4108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-30
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2700136101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health