Amanda McClure Hannon, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY004073 Issued in GA

Practice address

55 Jefferson Pkwy BLDG a
Newnan, GA 30263-5813

Phone

(470) 869-0628

NPI assigned

Jan 18, 2017

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

Other names 1

• Amanda McClure 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

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.

• The Life Change Group

  • Counseling Psychologist
  • Peachtree City, GA
  • NPI 1790159598
  NPD (past)
• Woven Paths Counseling LLC

  • Community/Behavioral Health Agency
  • Peachtree City, GA
  • NPI 1023966272
  NPD (past)
• Heal Doctors Ihwa, P.C.

  • Internal Medicine Physician
  • Baton Rouge, LA
  • NPI 1447917125
  NPD (past)

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

{
    "created_epoch": "1484697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580774400000",
    "number": "1124564869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 JOHNSTON AVE",
            "city": "PALMETTO",
            "state": "GA",
            "postal_code": "302681027",
            "telephone_number": "615-604-0336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 JEFFERSON PKWY BLDG A",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302635813",
            "telephone_number": "470-869-0628"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "302 Stevens Entry",
            "address_purpose": "LOCATION",
            "city": "Peachtree City",
            "state": "GA",
            "postal_code": "302691325",
            "country_code": "US",
            "telephone_number": "770-486-4887",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANNON",
        "first_name": "AMANDA",
        "middle_name": "MCCLURE",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-18",
        "last_updated": "2020-02-04",
        "certification_date": "2020-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY004073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "MCCLURE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Stephen Thomas Hammond
• Tin L Han, MD
• Callie Hand, BS
• Kristi Lashun Hand, NP
• Hanger Prosthetics & Orthotics, Inc
• Donna Williamson Hansman, LPC
• William Evan Hardin, CRNA
• Toccara Hardrick
• Delta McSha Hardy, R.T.(R)(ARRT)
• Lorraine Hardy, NP

• Psychologist in Newnan, GA
• Providers in Newnan, GA by specialty
• Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2020; 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.