Amanda L Gugliano, PSY.D. – Clinical Psychologist

Key facts

NPI: 1811245277
Entity type: Individual (NPI type 1)
Primary specialty: Clinical Psychologist 103TC0700X
License: 50875 (MS)
Practice address: 1490 W Government St
Suite 7
Brandon, MS 39042-3024
Phone: (601) 351-8606
NPI assigned: Aug 16, 2012
Sex: Female
Sole proprietor: No

Organizations & group practices 1

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.

Forensic Psychological Services LLC Clinical Psychologist · Ridgeland, MS · NPI 1164872867

NPD (past) CLINICAL

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
50875	MS	MD	Clinical Psychologist
4243	NC	MD	General Practice Dentistry

Practice roles

Organization	Specialty	Status	New patients
Forensic Psychological Services LLC	Clinical	Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Clinical Psychologist	103TC0700X	50875	MS	Yes
Clinical Psychologist	103TC0700X	4243	NC

Addresses

Primary practice location

1490 W Government St
Suite 7
Brandon, MS 39042-3024

Mailing address

1490 W Government St
Suite 7
Brandon, MS 39042-3024

Other providers in Brandon, MS

All providers in Brandon, MS · Clinical Psychologist in Mississippi

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 14, 2016. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.