Amy Burbage, PH.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

20041902A Issued in IN

Practice address

11232 Woods Bay LN
Indianapolis, IN 46236-7601

Phone

(317) 826-1082

NPI assigned

Dec 11, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Amy Coffield Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: aburbage39018@direct.franciscanalliance.org

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.

• Amy Burbage LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Carmel, IN
  • NPI 1740985795
  NPD Authorized official

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

{
    "created_epoch": "1228953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703548800000",
    "number": "1104061605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11232 WOODS BAY LN",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462367601",
            "telephone_number": "317-826-1082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11232 WOODS BAY LN",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462367601",
            "telephone_number": "317-826-1082"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5230 E Stop 11 Rd Ste 350",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462376402",
            "country_code": "US",
            "telephone_number": "317-783-8383",
            "fax_number": "317-782-6929",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11495 Pennsylvania St Ste 126",
            "address_purpose": "LOCATION",
            "city": "Carmel",
            "state": "IN",
            "postal_code": "460326804",
            "country_code": "US",
            "telephone_number": "317-643-3775",
            "fax_number": "317-663-2927",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURBAGE",
        "first_name": "AMY",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-11",
        "last_updated": "2023-12-26",
        "certification_date": "2023-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20041902A",
            "primary": true
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "IN",
            "license": "20041902A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200953890",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "COFFIELD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Katherine Bunner, PHARMD
• Michael J Buran, MD
• David Burand, RPH
• Buraq Holding LLC
• Courtney L Buratto, NP
• Rachel Marie Burbrink
• Arden Burch, DC
• Patricia Burch, PHARMD
• Sebastian Burch
• Tracy Lynn Burch, RD, CNSC

• Clinical Psychologist in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Clinical Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2023; 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.