MEDICARE: DR. AMY GREENBERG PSYD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1083423503
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMY GREENBERG PSYD

Provider Business Mailing Address
First Line	:	1940 STERLING OAKS CIR NE
Second Line	:
City	:	BROOKHAVEN
State	:	GA
Zip	:	30319-4129
Country	:	US
Telephone Number	:	404-797-3187
Fax Number	:

Provider Business Practice Location Address
First Line	:	1940 STERLING OAKS CIR NE
Second Line	:
City	:	BROOKHAVEN
State	:	GA
Zip	:	30319-4129
Country	:	US
Telephone Number	:	404-797-3187
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/31/2024
Last Update Date	:	12/31/2024

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