Amanda Eberle, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

38459 Issued in TX

Practice address

1420 FM 1960 Bypass Rd E Ste 116
Humble, TX 77338-3934

Phone

(713) 457-4372

Fax

(713) 457-0945

NPI assigned

Aug 5, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Stonebridge Behavioral Health, P.a.Group PAC ID 3274563929, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Stonebridge Behavioral Health, P.a.

  • Clinical Psychologist
  • San Antonio, TX
  • NPI 1861528390
  Medicare reassignment Care Compare group NPD
• Kinghaven Counseling Group Inc

  • Case Management Agency
  • Houston, TX
  • NPI 1396807350
  Medicare reassignment NPD

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

{
    "created_epoch": "1249430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601510400000",
    "number": "1013148360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6315 GULFTON ST STE 100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770811107",
            "telephone_number": "713-457-4372",
            "fax_number": "713-457-0945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 FM 1960 BYPASS RD E STE 116",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773383934",
            "telephone_number": "713-457-4372",
            "fax_number": "713-457-0945"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6315 Gulfton St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770811107",
            "country_code": "US",
            "telephone_number": "713-457-4372",
            "fax_number": "713-457-0945",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "502 Farrell Dr",
            "address_purpose": "LOCATION",
            "city": "Covington",
            "state": "KY",
            "postal_code": "410113717",
            "country_code": "US",
            "telephone_number": "859-578-3200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EBERLE",
        "first_name": "AMANDA",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-05",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "SC",
            "license": "1269",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "KY",
            "license": "NOO-353-270",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "38459",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "413475101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eagle'S Nest Medical Center
• Lamon Donell Easely Jr.
• East Texas Eye Center PA
• Eastern Home Health Care Services, Inc.
• Angie Tanshea Eaton
• Danielle Dana Ebron, FNP-C
• Jaryce Echols, BCACP
• Edgar a Jammer
• Kiesa Ann Edgar, FNP-BC
• Edloe Imaging Humble LLC

• Clinical Psychologist in Humble, TX
• Providers in Humble, TX by specialty
• Clinical Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.