Provider Demographics
NPI:1073206835
Name:BURRELL, ADRIENNE (LMSW)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:
Last Name:BURRELL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2528 MOUNTAIN RD STE 204
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:MD
Mailing Address - Zip Code:21122-7204
Mailing Address - Country:US
Mailing Address - Phone:443-548-3733
Mailing Address - Fax:410-360-1675
Practice Address - Street 1:2528 MOUNTAIN RD STE 102-204
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122-7203
Practice Address - Country:US
Practice Address - Phone:443-548-3733
Practice Address - Fax:410-360-1675
Is Sole Proprietor?:No
Enumeration Date:2023-05-30
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD249881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical