Amanda M Distasio, PH.D.

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

021930 Issued in NY

Practice address

111 County Cir
Middlesex BLDG
Amherst, MA 01003-9255

Phone

(413) 545-2337

Fax

(413) 545-9602

NPI assigned

Sep 3, 2010

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.

• Umass Health Services Amherst

  • Family Medicine Physician
  • Amherst, MA
  • NPI 1487688677
  NPD (past)

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

{
    "created_epoch": "1283472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683072000000",
    "number": "1902113590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 COUNTY CIR",
            "address_2": "MIDDLESEX BLDG",
            "city": "AMHERST",
            "state": "MA",
            "postal_code": "010039255",
            "telephone_number": "413-545-2337",
            "fax_number": "413-545-9602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 COUNTY CIR",
            "address_2": "MIDDLESEX BLDG",
            "city": "AMHERST",
            "state": "MA",
            "postal_code": "010039255",
            "telephone_number": "413-545-2337",
            "fax_number": "413-545-9602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISTASIO",
        "first_name": "AMANDA",
        "middle_name": "M",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-03",
        "last_updated": "2023-05-03",
        "certification_date": "2023-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MA",
            "license": "11228",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NY",
            "license": "021930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frank Joseph Dezenzo, LICSW
• Kathleen J Dezenzo, LICSW
• Jyotika Dhawan
• Andrea Ange Dibenedetto, ED.D.
• Pooja Dipanker
• Katherine Lee Dixon-Gordon, PH.D.
• Julie A Domeier, LCSW-R
• Patricia Ann Donahue, MSN/MBA, APRN - BC
• Amber N Douglas, PHD
• Downtown Therapy Associates LLC

• Counseling Psychologist in Amherst, MA
• Providers in Amherst, MA by specialty
• Counseling Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 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.