Amanda Domangue Bourg, PHD
NPI 1386758068ActiveIndividual· Psychologist, Counseling· Tellico Plains, TN
Psychologist, Counseling (PHD) in Tellico Plains, Tennessee, licensed in TN and LA, with an NPI issued in August 2006.
Overview
| NPI | 1386758068 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PHD |
| Sole proprietor | No |
| NPI issued | Aug 18, 2006 |
| Last updated in NPPES | Oct 13, 2022 |
| Certified by provider | Oct 13, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Counseling Primary | 103TC1900X | 3783 | TN |
| Psychologist, Counseling | 103TC1900X | 915 | LA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
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