Individual provider Active NPI

Amanda S. Lochrie, PHD

  • Clinical Child & Adolescent Psychologist
  • Jacksonville, FL
National Provider Identifier
1275649196
Registry record updated Sep 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
PY6796 Issued in FL
Practice address
807 Childrens Way
Jacksonville, FL 32207-8426
Phone
(904) 390-3698
Fax
(904) 390-3429
NPI assigned
Aug 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X PY6796 FL Primary

Addresses

Primary practice location

807 Childrens Way
Jacksonville, FL 32207-8426

Mailing address

PO Box 191
Provider Enrollment Dept
Rockland, DE 19732-0191
Phone (302) 651-6212

Other identifiers 1

IdentifierTypeStateIssuer
666505152AMedicaidGA

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

LicenseStateTypeSpecialty
PY6796FLMDClinical Child & Adolescent Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316736000000",
    "number": "1275649196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191",
            "address_2": "PROVIDER ENROLLMENT DEPT",
            "city": "ROCKLAND",
            "state": "DE",
            "postal_code": "197320191",
            "telephone_number": "302-651-6212",
            "fax_number": "302-651-4945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 CHILDRENS WAY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078426",
            "telephone_number": "904-390-3698",
            "fax_number": "904-390-3429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCHRIE",
        "first_name": "AMANDA",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2011-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "FL",
            "license": "PY6796",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "666505152A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2011; 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.