Basic Information
| Provider Information | |||||||||
| NPI: | 1528696952 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PIAS-HAGE | ||||||||
| FirstName: | JENNIFER | ||||||||
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| Credential: | LMHC | ||||||||
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| Mailing Information | |||||||||
| Address1: | FOUR WINDS SARATOGA | ||||||||
| Address2: | 30 CRESCENT AVE | ||||||||
| City: | SARATOGA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 12866 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5185843600 | ||||||||
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| Practice Location | |||||||||
| Address1: | 172 ELM ST | ||||||||
| Address2: | |||||||||
| City: | COBLESKILL | ||||||||
| State: | NY | ||||||||
| PostalCode: | 120434674 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5189488361 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/31/2020 | ||||||||
| LastUpdateDate: | 03/31/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/31/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 010346 | NY | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.