Amanda M Smith, PHD

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

37443 Issued in TX

Practice address

3304 Colorado Blvd Ste 102
Denton, TX 76210-6872

Phone

(940) 484-4311

Fax

(940) 484-5075

NPI assigned

Jul 25, 2016

Last updated

May 28, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: asmith17065@cookchildrens.direct-ci.com

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.

• Cook Children's Medical Center

  • Clinical Child & Adolescent Psychologist
  • Fort Worth, TX
  • NPI 1710702907
  Medicare reassignment NPD
• Cook Children's Medical Center

  dba Teddy Bear Transport

  • Air Ambulance
  • Fort Worth, TX
  • NPI 1215907530
  NPD

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

{
    "created_epoch": "1469404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1205389491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 99213",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761990213",
            "telephone_number": "682-885-1860",
            "fax_number": "682-885-1396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3304 COLORADO BLVD STE 102",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762106872",
            "telephone_number": "940-484-4311",
            "fax_number": "940-484-5075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "AMANDA",
        "middle_name": "M",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-25",
        "last_updated": "2024-05-28",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "TX",
            "license": "37443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "asmith17065@CookChildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "3201 Teasley Ln",
            "address_2": "STE 202",
            "city": "Denton",
            "state": "TX",
            "country_code": "US",
            "postal_code": "762108302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Smile Workshop Denton, PLLC (Ideal Dental Denton Crossing)
• Smiley Dental - University (Smiley Dental - University PLLC)
• Smiley Dental Denton
• Alayshia Kayvonne Smith-Douglas
• Alexandra Zachary Smith, RBT
• Brandon Jacob Smith, DPT
• Christina Smith, LPC
• Claudia Gonzalez Smith
• David K Smith, RPH
• Dawnea Smith

• Counseling Psychologist in Denton, TX
• Providers in Denton, TX by specialty
• Counseling Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.