MEDICARE: DR. AMY B. GREENAMYER PH.D.

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	103TC1900X	Counseling Psychologist	129133	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7742724	OTHER	KY	AETNA
2	000000366511	OTHER	KY	BLUE SHIELD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	787418000	OTHER	KY	MAGELLAN

General Provider Information

NPI Number	:	1871572313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMY B. GREENAMYER PH.D.

Provider Business Mailing Address
First Line	:	7984 NEW LA GRANGE RD
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40222-4718
Country	:	US
Telephone Number	:	502-426-2777
Fax Number	:	502-426-2776

Provider Business Practice Location Address
First Line	:	7984 NEW LA GRANGE RD
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40222-4718
Country	:	US
Telephone Number	:	502-426-2777
Fax Number	:	502-426-2776

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

Provider Enumeration Date	:	01/12/2006
Last Update Date	:	08/08/2020

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