Amanda Dougherty, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY9351 Issued in FL

Practice address

3401 W Truman Blvd Ste 100
Jefferson City, MO 65109-5752

Phone

(573) 644-7909

Fax

(573) 644-7908

NPI assigned

Apr 17, 2006

Last updated

Aug 15, 2023By 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 2

Addresses

Other identifiers 1

Other names 1

• Amanda Nelson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 1, 2024 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• True Joy Counseling and Consulting, PLLC

  • Mental Health Counselor
  • Niceville, FL
  • NPI 1487020368

  Clinical

  NPD

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1841255684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1041 JOHN SIMS PKWY E",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325782712",
            "telephone_number": "850-389-8489",
            "fax_number": "844-377-9201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 W TRUMAN BLVD STE 100",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651095752",
            "telephone_number": "573-644-7909",
            "fax_number": "573-644-7908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "AMANDA",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-17",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "2006031373",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY9351",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "497336206",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "NELSON",
            "credential": "PSY.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Shelley Rae Donahue, ECSE, TVI/COMS
• Taylor Donahue
• Stanley K Dorst, MD
• Dora Doss, MS, CCC-SLP
• Sara Doty
• Kelly Marie Douglas, M.D.
• Barbara Jean Douglass, LCSW
• Mary Elaine Doyle, RN, BC, M
• Dr Jeffrey Brooks PC
• Dr McCarty Clinical Psychologist LLC

• Clinical Psychologist in Jefferson City, MO
• Providers in Jefferson City, MO by specialty
• Clinical Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.