Healthcare Provider Details

I. General information

NPI: 1417323858
Provider Name (Legal Business Name): AMANDA BERNS PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2015
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1435 31ST ST NE
CEDAR RAPIDS IA
52402-4056
US

IV. Provider business mailing address

1435 31ST ST NE
CEDAR RAPIDS IA
52402-4056
US

V. Phone/Fax

Practice location:
  • Phone: 319-212-6810
  • Fax: 319-251-5880
Mailing address:
  • Phone: 319-212-6810
  • Fax: 319-251-5880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number100100
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: