Amanda Myers Campos, PSYD
Individual provider Active NPI Clinical Psychologist · Hoover, AL
NPI 1104170240 · NPPES record last updated Jul 9, 2021
Key facts
- NPI
- 1104170240
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 1996 (AL)
- Practice address
- 2408 Scepter LN
Hoover, AL 35226-2902 - Phone
- (205) 370-5156
- NPI assigned
- Oct 26, 2012
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2408 Scepter LN
Hoover, AL 35226-2902
Phone (205) 370-5156
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160414000542 | AL | Practitioner - Psychologist Billing Independently | 6103124748 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Telewellness Therapy, LLC | Single Specialty | Current |
Accepting new patients |
| SVPS Psychiatric Services LLC | Single Specialty | Past | Accepting new patients |
Locations
2007 3rd Ave N
Birmingham, AL 35203
Phone (205) 370-5156
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Clinical Psychologist |
103TC0700X | 1996 | AL | Yes |
Addresses
Primary practice location
2408 Scepter LN
Hoover, AL 35226-2902
Mailing address
2408 Scepter LN
Hoover, AL 35226-2902
Phone (205) 370-5156
Other practice location 1
2007 3rd Ave N
Birmingham, AL 35203-3301
Phone (205) 370-5156
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01261511 | Medicaid | CA |
Other providers in Hoover, AL
- Scott E Caldwell
- Dorinda Fay Cale
- Camellia Imaging LLC
- Donald Davis Campbell III
- Emileigh Ruth Campbell
- Sadie Jane Cancilla
- Emily Cantrell
- Camora Canty
- Capital Medical Systems LLC
- Care With Flair, LLC
All providers in Hoover, AL · Clinical Psychologist in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.