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AMANDA DOMANGUE BOURG PHD NPI 1386758068


NPI Information

NPI: 1386758068
Provider Name: AMANDA DOMANGUE BOURG, PHD
Classification: Psychologist - 103TC1900X
Entity Type: Individual

Specialization: Counseling

PECOS Registration: Yes

Address:
171 BANK ST # 221
TELLICO PLAINS, TN
ZIP 37385
Phone: (443) 379-0447
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Amanda Domangue Bourg, PHD is a counseling psychologist in Tellico Plains, TN. The provider is a psychologist who specializes in general practice and health service. It focuses on how people function both personally and in their relationships at all ages. Counseling psychology addresses the emotional, social, work, school and physical health concerns people may have at different stages in their lives, focusing on typical life stresses and more severe issues with which people may struggle as individuals and as a part of families, groups and organizations. Counseling psychologists help people with physical, emotional and mental health issues improve their sense of well-being, alleviate feelings of distress and resolve crises. They also provide assessment, diagnosis, and treatment of more severe psychological symptoms. Amanda Domangue Bourg, PHD NPI is 1386758068. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

171 BANK ST # 221
TELLICO PLAINS, TN
ZIP 37385-987
Phone: (443) 379-0447

The NPI 1386758068 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 8/18/2006 and was last updated on 10/13/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103TC1900XPsychologistCounseling3783TENNESSEEYes
2103TC1900XPsychologistCounseling915LOUISIANANo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1915OTHERLOUISIANASTATE PSYCHOLOGY LICENSE
23783OTHERTENNESSEESTATE PSYCHOLOGY LICENSURE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.