Individual provider Active NPI

Amanda Aaron Hackwell, PHD

  • Psychologist
  • Phoenix, AZ
National Provider Identifier
1003589169
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY-005165 Issued in AZ
Practice address
11431 N 39TH PL
Phoenix, AZ 85028-2102
Phone
(541) 646-6442
NPI assigned
Jul 26, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY-005165 AZ Primary

Addresses

Primary practice location

11431 N 39TH PL
Phoenix, AZ 85028-2102

Mailing address

11431 N 39TH PL
Phoenix, AZ 85028-2102
Phone (541) 646-6442

Other practice location 1

2001 W Orange Grove Rd Ste 500
Tucson, AZ 85704-1106
Phone (520) 277-2190

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY-005165AZMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Developmental Psychology Psychologist CurrentSince Jan 8, 2023 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1627257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1003589169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11431 N 39TH PL",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850282102",
            "telephone_number": "541-646-6442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11431 N 39TH PL",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850282102",
            "telephone_number": "541-646-6442"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2001 W Orange Grove Rd Ste 500",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857041106",
            "country_code": "US",
            "telephone_number": "520-277-2190",
            "fax_number": "317-520-8200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HACKWELL",
        "first_name": "AMANDA",
        "middle_name": "AARON",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-26",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AZ",
            "license": "PSY-005165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.