Healthcare Provider Details

I. General information

NPI: 1558298455
Provider Name (Legal Business Name): AMBER E BURRELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2233 GARNET PL
COLUMBUS OH
43232-3904
US

IV. Provider business mailing address

2233 GARNET PL
COLUMBUS OH
43232-3904
US

V. Phone/Fax

Practice location:
  • Phone: 614-972-3619
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: