Active NPI
Kelly L Burrow, LCMHT
- Mental Health Counselor
- Tupelo, MS
National Provider Identifier
1073604385
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 0431
- Practice address
- Region III Mental Health Center
2434 South Eason Blvd
Tupelo, MS 38804-6942 - Phone
- (662) 842-9217
- Fax
- (662) 680-1601
- NPI assigned
- Sep 28, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 0431 | MS | Primary |
Addresses
Primary practice location
Region III Mental Health Center
2434 South Eason Blvd
Tupelo, MS 38804-6942
Mailing address
PO Box 1370
Saltillo, MS 38866
Phone (662) 869-2138
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0431 | MS | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1073604385",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1370",
"city": "SALTILLO",
"state": "MS",
"postal_code": "38866",
"telephone_number": "662-869-2138",
"fax_number": "662-680-1601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "REGION III MENTAL HEALTH CENTER",
"address_2": "2434 SOUTH EASON BLVD",
"city": "TUPELO",
"state": "MS",
"postal_code": "388046942",
"telephone_number": "662-842-9217",
"fax_number": "662-680-1601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURROW",
"first_name": "KELLY",
"middle_name": "L",
"name_prefix": "Mrs.",
"credential": "LCMHT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MS",
"license": "0431",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tupelo, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.