AMANDA L MOEN PHD
NPI 1720570773
Psychologist in Fort Worth, TX

Active since June 05, 2018PECOS Enrolled
1300 W LANCASTER AVE, FORT WORTH, TX 76102(682) 303-9200(682) 303-9239 Get Directions Write a Review

NPPES record last updated: December 20, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 20, 2022, Aug 3, 2021 (2 updates tracked since 2021).

About Amanda L Moen Phd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AMANDA L MOEN PHD (NPI 1720570773) is an individual psychologist in Fort Worth, Texas, licensed in Texas (38514) and active in the NPI registry since June 2018. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1720570773
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameAMANDA L MOENCredential: PHD
Location Address1300 W LANCASTER AVEFort Worth, TX 76102-3499
Mailing Address1300 W Lancaster AveFort Worth, TX 76102-3499 · (682) 303-9200 · Fax (682) 303-9239
Fax(682) 303-9239
Sole ProprietorNo
Enumeration DateJune 5, 2018
Last NPPES UpdateDecember 20, 20222 updates tracked since enumeration
NPPES CertifiedDecember 20, 2022
✔ NPI 1720570773 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License✔ Licensed in TX · 38514
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
1300 W LANCASTER AVE, Fort Worth, TX 76102

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Amanda L Moen Phd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Amanda Moen reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Clinical Child & Adolescent
1500 COOPER ST
Fort Worth, TX 76104
  • Reassigned Medicare billing, Texas enrollment
  • 30 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Pediatrics (Developmental - Behavioral Pediatrics)
1300 W LANCASTER AVE
FORT WORTH, TX 76102
Audiologist
1300 W LANCASTER AVE, STE 106
FORT WORTH, TX 76102
Behavior Analyst
1300 W LANCASTER AVE, STE 205
FORT WORTH, TX 76102
Pediatrics (Neurodevelopmental Disabilities)
1300 W LANCASTER AVE
FORT WORTH, TX 76102
Counselor (Professional)
1300 W LANCASTER AVE
FORT WORTH, TX 76102
Genetic Counselor, MS
1300 W LANCASTER AVE, STE 204
FORT WORTH, TX 76102
Behavior Analyst
1300 W LANCASTER AVE
FORT WORTH, TX 76102
Pediatrics
1300 W LANCASTER AVE, STE 101
FORT WORTH, TX 76102

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Amanda Moen's NPI number?

The NPI number for Amanda Moen is 1720570773. It was assigned to this individual provider in the NPPES registry on June 5, 2018.

Where is Amanda Moen located?

Amanda Moen practices at 1300 W Lancaster Ave, Fort Worth, TX 76102. The listed phone number is (682) 303-9200.

What is Amanda Moen's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Amanda Moen enrolled in Medicare?

Yes. Amanda Moen is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Amanda Moen's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Amanda Moen reassigns Medicare benefits to Cook Children's Medical Center (Fort Worth, TX). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Amanda Moen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Amanda Moen accept?

Health plans from Imperial Insurance Companies, Inc. list Amanda Moen as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Amanda Moen was last updated on December 20, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.