Provider Demographics
NPI:1497074769
Name:AMY SERIN PHD PLLC
Entity Type:Organization
Organization Name:AMY SERIN PHD PLLC
Other - Org Name:THE SERIN CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NEUROPSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:SERIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:623-824-5051
Mailing Address - Street 1:9784 W YEARLING RD
Mailing Address - Street 2:B1580
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-1379
Mailing Address - Country:US
Mailing Address - Phone:623-824-5051
Mailing Address - Fax:623-825-6757
Practice Address - Street 1:9784 W YEARLING RD
Practice Address - Street 2:B1580
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85383-1379
Practice Address - Country:US
Practice Address - Phone:623-824-5051
Practice Address - Fax:623-825-6757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-25
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3859101YM0800X, 103G00000X, 103TB0200X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty