Amanda Walker, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY004528 Issued in GA

Practice address

45 N Gwinnett St
Buford, GA 30518-2619

Phone

(770) 823-4413

NPI assigned

Sep 27, 2021

Last updated

Sep 27, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1632700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632700800000",
    "number": "1629749957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 N GWINNETT ST",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305182619",
            "telephone_number": "770-823-4413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 N GWINNETT ST",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305182619",
            "telephone_number": "770-823-4413"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4046 Wetherburn Way",
            "address_purpose": "LOCATION",
            "city": "Peachtree Corners",
            "state": "GA",
            "postal_code": "300924660",
            "country_code": "US",
            "telephone_number": "770-696-4384",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALKER",
        "first_name": "AMANDA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-27",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY004528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Buford, GA
• Providers in Buford, GA by specialty
• Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2021; 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.