Amber K Penuel, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

05296 Issued in MD

Practice address

10776 Grays Corner Rd.
Suite 2
Berlin, MD 21811

Phone

(410) 213-7875

Fax

(410) 213-7877

NPI assigned

Nov 27, 2012

Last updated

Nov 2, 2016By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Seaside Counseling & Wellness Center

  • Clinical Social Worker
  • Berlin, MD
  • NPI 1922410109
  NPD (past)

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

{
    "created_epoch": "1353974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478044800000",
    "number": "1710221031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10776 GRAYS CORNER RD.",
            "address_2": "SUITE 2",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "21811",
            "telephone_number": "410-213-7875",
            "fax_number": "410-213-7877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10776 GRAYS CORNER RD.",
            "address_2": "SUITE 2",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "21811",
            "telephone_number": "410-213-7875",
            "fax_number": "410-213-7877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENUEL",
        "first_name": "AMBER",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-27",
        "last_updated": "2016-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "05296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peninsual Regional Medical Center
• Peninsula Eye Center, P.a. (Peninsula Eye Surgeons)
• Peninsula Orthopaedic Assoc PA
• Peninsula Plastic Surgery, P.C.
• Peninsula Regional Medical Center
• Breea Pepiot
• Monica Lyn Perella, M.A.,SLP-
• Gordana Peric Stepcic, MD
• Perinatal Wellness LLC
• Mosha Mashaun Peters-Harris, M.D.

• Clinical Psychologist in Berlin, MD
• Providers in Berlin, MD by specialty
• Clinical Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2016; 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.