Healthcare Provider Details

I. General information

NPI: 1407975311
Provider Name (Legal Business Name): CLIO VARDOPOULOS HATZIYANNAKIS PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

KELLER ARMY COMMUNITY HOSPITAL 900 WASHINGTON ROAD
WEST POINT NY
10996-1197
US

IV. Provider business mailing address

KELLER ARMY COMMUNITY HOSPITAL 900 WASHINGTON ROAD
WEST POINT NY
10996-1197
US

V. Phone/Fax

Practice location:
  • Phone: 845-938-3441
  • Fax: 845-938-5770
Mailing address:
  • Phone: 315-774-8221
  • Fax: 845-938-5770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number5488
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number013368-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: