Amelia Smith, PSYD., LLC.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

AMELIA SMITH, PSYD., LLC.

Practice address

1345 NW Wall St Ste 303
Bend, OR 97703-1970

Phone

(541) 819-0706

NPI assigned

Aug 6, 2019

Organization subpart

No

Name

Dr. Amelia Anne Smith, PSYD.NPI 1184056756

Title

Licensed Psychologist

Phone

(541) 819-0706

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Amelia Anne Smith, PSYD.

  • Clinical Psychologist
  • Bend, OR
  • NPI 1184056756
  NPD Authorized official CLINICAL

• Downtown Psychological Services Other name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 5, 2019.

{
    "created_epoch": "1565049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567641600000",
    "number": "1992350987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1345 NW WALL ST STE 303",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977031970",
            "telephone_number": "541-819-0706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 NW WALL ST STE 303",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977031970",
            "telephone_number": "541-819-0706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMELIA SMITH, PSYD., LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-06",
        "last_updated": "2019-09-05",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "AMELIA",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "541-819-0706",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Downtown Psychological Services",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Downtown Psychological Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• All providers in Bend, OR
• Clinical Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2019; 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.