Individual provider Active NPI

Amanda Lower Burke, PH.D.

  • Clinical Psychologist
  • Edmond, OK
National Provider Identifier
1356622260
Registry record updated May 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1354 Issued in OK
Practice address
1733 W 33Rd St Ste 120
Edmond, OK 73013-3866
Phone
(405) 285-7332
Fax
(405) 285-7338
NPI assigned
Sep 6, 2011
Last updated
May 15, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1354 OK Primary

Addresses

Primary practice location

1733 W 33Rd St Ste 120
Edmond, OK 73013-3866

Mailing address

3417 Persimmon Creek Dr
Edmond, OK 73013-7849
Phone (405) 613-8944

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
1354OKMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Angela Ridings Counseling LLC PastSince May 17, 2020 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1315267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589500800000",
    "number": "1356622260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3417 PERSIMMON CREEK DR",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730137849",
            "telephone_number": "405-613-8944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1733 W 33RD ST STE 120",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730133866",
            "telephone_number": "405-285-7332",
            "fax_number": "405-285-7338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKE",
        "first_name": "AMANDA",
        "middle_name": "LOWER",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-06",
        "last_updated": "2020-05-15",
        "certification_date": "2020-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OK",
            "license": "1354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2020; 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.