| Gabrielle P. Hackett, Psy.d., Llc | |
|
1575 Indian River Blvd Ste C225 Vero Beach FL 32960-7127 | |
| (954) 812-3482 | |
| (954) 900-1197 |
| Full Name | Gabrielle P. Hackett, Psy.d., Llc |
|---|---|
| Speciality | Psychologist |
| Location | 1575 Indian River Blvd Ste C225, Vero Beach, Florida |
| Authorized Official Name and Position | Gabrielle Paige Hackett (OWNER) |
| Authorized Official Contact | 9548123482 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gabrielle P. Hackett, Psy.d., Llc 18601 Tranquility Base Ln Port St Lucie FL 34987-3236 Ph: (954) 812-3482 | Gabrielle P. Hackett, Psy.d., Llc 1575 Indian River Blvd Ste C225 Vero Beach FL 32960-7127 Ph: (954) 812-3482 |
| NPI Number | 1194263632 |
|---|---|
| Provider Enumeration Date | 02/04/2017 |
| Last Update Date | 06/07/2022 |
| Certification Date | 06/07/2022 |
| Medicare PECOS PAC ID | 0143597559 |
|---|---|
| Medicare Enrollment ID | O20170606000590 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194263632 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY9507 (Florida) | Primary |
| Provider Name | Gabrielle P Hackett |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1407200645 PECOS PAC ID: 2961779376 Enrollment ID: I20170719003758 |
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