Healthcare Provider Details

I. General information

NPI: 1508791088
Provider Name (Legal Business Name): ELLEN HALADY PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1280 SW 36TH AVE STE 206
POMPANO BEACH FL
33069-4838
US

IV. Provider business mailing address

1280 SW 36TH AVE STE 206
POMPANO BEACH FL
33069-4838
US

V. Phone/Fax

Practice location:
  • Phone: 716-474-8604
  • Fax:
Mailing address:
  • Phone: 754-300-9137
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPY13113
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: