Provider Demographics
NPI:1871572313
Name:GREENAMYER, AMY B (PHD)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:B
Last Name:GREENAMYER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7984 NEW LA GRANGE RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-4718
Mailing Address - Country:US
Mailing Address - Phone:502-426-2777
Mailing Address - Fax:502-426-2776
Practice Address - Street 1:7984 NEW LA GRANGE RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-4718
Practice Address - Country:US
Practice Address - Phone:502-426-2777
Practice Address - Fax:502-426-2776
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-12
Last Update Date:2020-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY129133103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7742724OtherAETNA
KY000000366511OtherBLUE SHIELD
KY8900103600Medicaid
KY787418000OtherMAGELLAN
KY8900103600Medicaid