Provider Demographics
NPI:1194850859
Name:MURRELL COUNSELING SERVICE, LLC
Entity Type:Organization
Organization Name:MURRELL COUNSELING SERVICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:MURRELL
Authorized Official - Suffix:
Authorized Official - Credentials:PSY D
Authorized Official - Phone:417-881-1580
Mailing Address - Street 1:2200 E SUNSHINE ST STE 312
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-1883
Mailing Address - Country:US
Mailing Address - Phone:417-881-1580
Mailing Address - Fax:417-881-7004
Practice Address - Street 1:2200 E SUNSHINE ST STE 312
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-1883
Practice Address - Country:US
Practice Address - Phone:417-881-1580
Practice Address - Fax:417-881-7004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOPYO1215103G00000X
MOPYO1874103TC0700X, 305S00000X
MOPYO1137103TC0700X
MOPYO029922103TC0700X
MO20020323521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Not Answered305S00000XManaged Care OrganizationsPoint of Service