Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Amber Lee Fasula, PSYD, BCN

Individual provider Clinical Psychologist · NPI 1730364472

Dr. Amber Lee Fasula, PSYD, BCN is a Clinical Psychologist in Maitland, Florida. Qualified in 2008, 18 years ago. Practices with Neurogenesis Center of Florida PLLC, a 5-clinician group and accepts Medicare assignment. Licensed in Florida and Illinois.

Years since qualifying
18
Licensed in
FL, IL
In the registry since
2007
Specialties on file
2
What do these letters mean?
PSYD — Doctor of Psychology
A doctoral psychologist trained primarily for clinical practice.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

253 N Orlando Ave Ste 202
Maitland, FL 32751
Phone: (407) 790-4101
Fax: (407) 277-4400
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence PY9333 (FL)
Clinical Psychologist Taxonomy 103TC0700X · Licence 071007844 (IL)

Record details

NPI number1730364472
Entity typeIndividual (Type 1)
GenderFemale
Credentials PSYD , BCN
Sole proprietorNo
NPI enumeratedDecember 31, 2007
Last updated in NPPESMarch 31, 2021
Certification dateMarch 31, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Neurogenesis Center Of Florida Pllc — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Maitland