Individual provider Active NPI

Amanda Marie Cardell, PSYD

  • Psychologist
  • Alpharetta, GA
National Provider Identifier
1710615059
Registry record updated Aug 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
071.010812 Issued in IL
Practice address
785 Hopewell Place Dr
Alpharetta, GA 30004-8101
Phone
(770) 324-2655
NPI assigned
Aug 14, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 071.010812 IL Primary

Addresses

Primary practice location

785 Hopewell Place Dr
Alpharetta, GA 30004-8101

Mailing address

785 Hopewell Place Dr
Alpharetta, GA 30004-8101
Phone (770) 324-2655

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

State licenses

LicenseStateTypeSpecialty
071.010812ILMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1660435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660435200000",
    "number": "1710615059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "785 HOPEWELL PLACE DR",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300048101",
            "telephone_number": "770-324-2655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "785 HOPEWELL PLACE DR",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300048101",
            "telephone_number": "770-324-2655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDELL",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-14",
        "last_updated": "2022-08-14",
        "certification_date": "2022-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071.010812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2022; 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.