Basic Information
| Provider Information | |||||||||
| NPI: | 1194850859 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MURRELL COUNSELING SERVICE, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2200 E SUNSHINE ST STE 312 | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MO | ||||||||
| PostalCode: | 658041883 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4178811580 | ||||||||
| FaxNumber: | 4178817004 | ||||||||
| Practice Location | |||||||||
| Address1: | 2200 E SUNSHINE ST STE 312 | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MO | ||||||||
| PostalCode: | 658041883 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4178811580 | ||||||||
| FaxNumber: | 4178817004 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/22/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | MURRELL | ||||||||
| AuthorizedOfficialFirstName: | MICHAEL | ||||||||
| AuthorizedOfficialMiddleName: | DAVID | ||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 4178811580 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | PSY. D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103G00000X | PYO1215 | MO | X | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Clinical Neuropsychologist | 103TC0700X | PYO1874 | MO | X | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist | Clinical | 103TC0700X | PYO1137 | MO | X | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist | Clinical | 103TC0700X | PYO029922 | MO | X | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist | Clinical | 1041C0700X | 2002032352 | MO | X | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | Clinical | 305S00000X | PYO1874 | MO | X | Managed Care Organizations | Point of Service |
No ID Information.