Active NPI
Randal K Burleson, PSY.D.
- Clinical Psychologist
- Huntsville, AL
National Provider Identifier
1063455194
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 570
- Practice address
- 4040 Memorial Pkwy SW
Huntsville, AL 35802-4364 - Phone
- (256) 533-1970
- Fax
- (256) 532-4112
- NPI assigned
- Jun 14, 2006
- Last updated
- Jul 13, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 570 | AL | Primary |
Addresses
Primary practice location
4040 Memorial Pkwy SW
Huntsville, AL 35802-4364
Mailing address
4040 Memorial Pkwy SW
Huntsville, AL 35802-4364
Phone (256) 533-1970
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 51502966BUR | Other | AL | FED BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 570 | AL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1063455194",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4040 MEMORIAL PKWY SW",
"city": "HUNTSVILLE",
"state": "AL",
"postal_code": "358024364",
"telephone_number": "256-533-1970",
"fax_number": "256-532-4112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4040 MEMORIAL PKWY SW",
"city": "HUNTSVILLE",
"state": "AL",
"postal_code": "358024364",
"telephone_number": "256-533-1970",
"fax_number": "256-532-4112"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURLESON",
"first_name": "RANDAL",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-14",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "AL",
"license": "570",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FED BCBS",
"identifier": "51502966BUR",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Huntsville, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.