Amanda Marie Divita Wiemken, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

06456 Issued in MD

Practice address

2431 Solomons Island Rd Ste 200
Annapolis, MD 21401-3730

Phone

(410) 757-2077

NPI assigned

Sep 15, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

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, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Arundel Mental Health Professionals LCGroup PAC ID 4981688173, 118 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Arundel Mental Health Professionals L.C.

  • Clinical Psychologist
  • Arnold, MD
  • NPI 1073649521
  Medicare reassignment Care Compare group NPD
• Arundel Mental Health Professionals LLC

  • Clinical Psychologist
  • Annapolis, MD
  • NPI 1053047894
  NPD
• Arundel Mental Health Professionals LLC

  • Clinical Psychologist
  • Crofton, MD
  • NPI 1497481246
  NPD (past)
• Arundel Mental Health Professionals LLC

  • Clinical Psychologist
  • Annapolis, MD
  • NPI 1649906496
  NPD (past)

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

{
    "created_epoch": "1600128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645401600000",
    "number": "1043825151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2431 SOLOMONS ISLAND RD STE 200",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013730",
            "telephone_number": "410-757-2077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2431 SOLOMONS ISLAND RD STE 200",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013730",
            "telephone_number": "410-757-2077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEMKEN",
        "first_name": "AMANDA",
        "middle_name": "MARIE DIVITA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-15",
        "last_updated": "2022-02-21",
        "certification_date": "2022-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MD",
            "license": "06456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsey M Whittaker, COTA/L
• Whole Home Health, LLC
• Whole Home Health, LLC
• Erin Wical, LCPC
• Cameron Reese Wiedel, BEHAVIOR TECHNICIAN
• Lori Wiener, LCSW-C, PHD
• Amanda Nicole Wiggins, LCMFT
• Kenneth Wijesinghe, LMT
• Valerie Kristine Wilder, PHD
• Wildman Optics Inc

• Psychologist in Annapolis, MD
• Providers in Annapolis, MD by specialty
• Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2022; 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.