Provider Demographics
NPI:1548359524
Name:AMANDA MORRICE-MCBRIDE, PSY.D., P.C.
Entity type:Organization
Organization Name:AMANDA MORRICE-MCBRIDE, PSY.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRICE-MCBRIDE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:361-883-1219
Mailing Address - Street 1:PO BOX 2503
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78403-2503
Mailing Address - Country:US
Mailing Address - Phone:361-883-1219
Mailing Address - Fax:361-887-1080
Practice Address - Street 1:101 N SHORELINE BLVD
Practice Address - Street 2:SUITE 301
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78401-2824
Practice Address - Country:US
Practice Address - Phone:361-883-1219
Practice Address - Fax:361-887-1080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30571103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00346499OtherMEDICARE RAILROAD CARRIER
TX1949703-01Medicaid
TX1027534-06Medicaid
TX0074RBOtherBC/BS GROUP NUMBER
TX1949703-01Medicaid