Healthcare Provider Details

I. General information

NPI: 1992623474
Provider Name (Legal Business Name): MEMORIA PSYCHIATRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 LANCASTER AVE
RICHMOND KY
40475-3100
US

IV. Provider business mailing address

521 LANCASTER AVE
RICHMOND KY
40475-3100
US

V. Phone/Fax

Practice location:
  • Phone: 832-282-4993
  • Fax:
Mailing address:
  • Phone: 832-282-4993
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: AMARA OBI
Title or Position: MANAGING MEMBER
Credential: APRN, PMHNP-BC
Phone: 832-282-4993