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NPI Code Detail

MEDICARE: AMBER PERKINS PSYD

MEDICARE: AMBER PERKINS 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
1103T00000XPsychologist2019036248MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
22019036248OTHERMOPSYCHOLOGIST LICENCE

General Provider Information

NPI Number : 1801361282
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMBER PERKINS PSYD
Provider Business Mailing Address
First Line : 2864 S NETTLETON AVE
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65807-5970
Country : US
Telephone Number : 417-605-7100
Fax Number : 417-708-0889
Provider Business Practice Location Address
First Line : 2864 S NETTLETON AVE
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65807-5970
Country : US
Telephone Number : 417-605-7100
Fax Number : 417-708-0889
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/11/2018
Last Update Date : 02/02/2026

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