Amanda Gail Whitacre, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

003916 Issued in CT

Practice address

1200 High Ridge Rd
Stamford, CT 06905-1223

Phone

(203) 580-3595

NPI assigned

Jul 29, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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 and National Provider Directory roles.

• Jewish Board of Family and Children Services

  • Early Intervention Provider Agency
  • New York, NY
  • NPI 1235512989
  NPD (past)

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

{
    "created_epoch": "1375056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600300800000",
    "number": "1770925018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "264 SOUND BEACH AVE APT 2N",
            "city": "OLD GREENWICH",
            "state": "CT",
            "postal_code": "068701614",
            "telephone_number": "203-940-3595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 HIGH RIDGE RD",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069051223",
            "telephone_number": "203-580-3595"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "34 W 139th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100371508",
            "country_code": "US",
            "telephone_number": "212-690-7234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITACRE",
        "first_name": "AMANDA",
        "middle_name": "GAIL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-29",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "003916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sonja Wessendorf, PT
• West Haven Vamc
• Rachel West
• Westchester Medical Group, P.C.
• Joshua Wetzler, MD
• Meagan White, M.ED., LSLS CERT. AV
• Samantha Denise White, PA-C
• Jeremy M. Whitfield, D.C.
• Julie Ann Whitmer
• Whole Soul Counseling LLC

• Clinical Psychologist in Stamford, CT
• Providers in Stamford, CT by specialty
• Clinical Psychologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 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.