Individual provider Active NPI

Adrienne P Henry, PSYD, LP

  • Clinical Psychologist
  • Springfield, MO
National Provider Identifier
1083287064
Registry record updated Sep 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2021033729 Issued in MO
Practice address
1300 E Bradford Pkwy
Springfield, MO 65804-4264
Phone
(417) 761-5000
Fax
(417) 761-5011
NPI assigned
Jul 19, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2021033729 MO Primary

Addresses

Primary practice location

1300 E Bradford Pkwy
Springfield, MO 65804-4264

Mailing address

1300 E Bradford Pkwy
Springfield, MO 65804-4264
Phone (417) 761-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240127000336 MO Practitioner - Clinical Psychologist 9436502374 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Burrell IncGroup PAC ID 4486548625, 217 clinicians

Practice addresses (Care Compare)

1300 E Bradford Pkwy
Springfield, MO 65804-4264

210 N Williams
Burrell Behavioral Health
Moberly, MO 65720-1583
Phone (660) 263-7651

2885 W Battlefield St
Springfield, MO 65807-3952
Phone (417) 761-5800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2021033729MOMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Burrell, Inc. CurrentSince Dec 24, 2023 Accepting new patients
Burrell, Inc. CurrentSince Dec 24, 2023 Accepting new patients

Locations

1300 E Bradford Pkwy
Bldg B
Springfield, MO 65804
Phone (417) 269-5400

1300 E Bradford Pkwy
Springfield, MO 65804
Phone (417) 269-5400

2885 W Battlefield St
Springfield, MO 65807
Phone (417) 761-5214

1300 E Bradford Pkwy
#H
Springfield, MO 65804

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1626652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663891200000",
    "number": "1083287064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 E BRADFORD PKWY",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658044264",
            "telephone_number": "417-761-5000",
            "fax_number": "417-761-5011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 E BRADFORD PKWY",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658044264",
            "telephone_number": "417-761-5000",
            "fax_number": "417-761-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "ADRIENNE",
        "middle_name": "P",
        "credential": "PSYD, LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-19",
        "last_updated": "2022-09-23",
        "certification_date": "2022-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "2021033729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.