Amelia Anne Smith, PSYD.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3112 Issued in OR

Practice address

1345 NW Wall St Ste 303
Bend, OR 97703-1970

Phone

(541) 819-0706

NPI assigned

Aug 6, 2013

Last updated

Dec 13, 2024By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 20, 2026 through Jan 20, 2028

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Amelia Smith, PSYD., LLC.

  • Clinical Psychologist
  • Bend, OR
  • NPI 1992350987
  NPD Authorized official

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

{
    "created_epoch": "1375747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1184056756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1345 NW WALL ST STE 303",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977031970",
            "telephone_number": "541-819-0706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 NW WALL ST STE 303",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977031970",
            "telephone_number": "541-819-0706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "AMELIA",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "PSYD.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-06",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "3112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Smelser, MSPT
• Kari Smerud, PA-C
• Alexa Christine Smith-Ellison, RN, CNM, WHNP
• Alexandra Caley Smith, RN, CNS
• Alexis Smith
• Amie Smith, MOT, OTR/L
• Amy Nichole Smith, RN
• Burl Amber Smith, PSS
• Cameron Phillip Smith
• Christopher Smith

• Clinical Psychologist in Bend, OR
• Providers in Bend, OR by specialty
• Clinical Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.