Amy Burbage LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

AMY BURBAGE LLC

Practice address

11495 Pennsylvania St Ste 126
Carmel, IN 46032-6804

Phone

(317) 643-3775

Fax

(317) 663-2927

NPI assigned

Mar 31, 2023

Last updated

Mar 31, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Amy Burbage, PH.D.NPI 1104061605

Title

Psychologist

Phone

(317) 509-5113

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Amy Burbage, PH.D

  • Clinical Psychologist
  • Indianapolis, IN
  • NPI 1104061605
  NPD Authorized official

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

{
    "created_epoch": "1680220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680220800000",
    "number": "1740985795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11495 PENNSYLVANIA ST STE 126",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460326804",
            "telephone_number": "317-643-3775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11495 PENNSYLVANIA ST STE 126",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460326804",
            "telephone_number": "317-643-3775",
            "fax_number": "317-663-2927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMY BURBAGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-31",
        "last_updated": "2023-03-31",
        "certification_date": "2023-03-31",
        "status": "A",
        "authorized_official_last_name": "BURBAGE",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "317-509-5113",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Amich, DHSC, NRP, MBA
• Chintan J Amin, MD
• Maliha Amir
• Rachel Ann Amos, RT, RN
• Krishna Amuluru, MD
• Traci Ananias, LCSW
• Daniel Ancaja, PT
• Laura Estel Andaluz-Scher, MD
• Brooke Andersen
• Benjamin H. Anderson, PA-C

• Mental Health Clinic/Center (Including Community Mental Health Center) in Carmel, IN
• Providers in Carmel, IN by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2023; 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.