Healthcare Provider Details

I. General information

NPI: 1245038389
Provider Name (Legal Business Name): ALMA J BURRELL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/05/2025
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4321 LEISURE TIME DR
DIAMONDHEAD MS
39525-3200
US

IV. Provider business mailing address

4321 LEISURE TIME DR
DIAMONDHEAD MS
39525-3200
US

V. Phone/Fax

Practice location:
  • Phone: 228-342-5776
  • Fax:
Mailing address:
  • Phone: 228-342-5776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC11306
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number18613
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: