Active NPI
Amanda Lienau Purnell, PH.D.
- Counseling Psychologist
- Saint Louis, MO
National Provider Identifier
1255563078
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 017993-1
- Practice address
- 915 N Grand Blvd
Saint Louis, MO 63106-1621 - Phone
- (614) 507-7572
- NPI assigned
- Aug 12, 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 |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 017993-1 | NY | Primary |
Addresses
Primary practice location
915 N Grand Blvd
Saint Louis, MO 63106-1621
Mailing address
1421 Dautel LN
Saint Louis, MO 63146-5488
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 017993-1 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250035200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1250035200000",
"number": "1255563078",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1421 DAUTEL LN",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631465488"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "915 N GRAND BLVD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631061621",
"telephone_number": "614-507-7572"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PURNELL",
"first_name": "AMANDA",
"middle_name": "LIENAU",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-08-12",
"last_updated": "2009-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "NY",
"license": "017993-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.