Active NPI
Amanda Adams-Mock, PSY.D.
- Clinical Psychologist
- Gallipolis, OH
National Provider Identifier
1205060829
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6518
- Practice address
- 3086 State Route 160
Gallipolis, OH 45631-8409 - Phone
- (740) 446-5500
- Fax
- (740) 441-4402
- NPI assigned
- May 11, 2009
- Last updated
- May 18, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6518 | OH | Primary |
Addresses
Primary practice location
3086 State Route 160
Gallipolis, OH 45631-8409
Mailing address
3086 State Route 160
Gallipolis, OH 45631-8409
Phone (740) 446-5500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6518 | OH | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1242000000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1242604800000",
"number": "1205060829",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3086 STATE ROUTE 160",
"city": "GALLIPOLIS",
"state": "OH",
"postal_code": "456318409",
"telephone_number": "740-446-5500",
"fax_number": "740-441-4402"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3086 STATE ROUTE 160",
"city": "GALLIPOLIS",
"state": "OH",
"postal_code": "456318409",
"telephone_number": "740-446-5500",
"fax_number": "740-441-4402"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADAMS-MOCK",
"first_name": "AMANDA",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-05-11",
"last_updated": "2009-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OH",
"license": "6518",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gallipolis, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.