MEDICARE: BURRELL, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0855X	Adolescent and Children Mental Health Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114055076
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BURRELL, INC.

Provider Business Mailing Address
First Line	:	2885 W BATTLEFIELD ST
Second Line	:
City	:	SPRINGFIELD
State	:	MO
Zip	:	65807-3952
Country	:	US
Telephone Number	:	417-761-5000
Fax Number	:	417-761-5011

Provider Business Practice Location Address
First Line	:	3401 BERRYWOOD DR STE 101
Second Line	:
City	:	COLUMBIA
State	:	MO
Zip	:	65201-6515
Country	:	US
Telephone Number	:	573-777-7528
Fax Number	:	573-777-7587

Authorized Official
Title or Position	:	VP MANAGED CARE
Name	:	AMANDA R CARTER
Credential	:
Telephone Number	:	417-761-5126

Provider Enumeration Date	:	03/01/2007
Last Update Date	:	03/13/2026

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Directions to “BURRELL, INC. ” Practice Location

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