Erin Elizabeth Burrell, PSY.D., HSPP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

20042902A Issued in IN

Practice address

1118 Jackson PL
Dyer, IN 46311-1457

Phone

(773) 870-9079

NPI assigned

May 19, 2018

Last updated

Jan 12, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN, IL2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Premise Health of Illinois Medical PC

  dba Mount Vernon Health Center Mt Vernon

  • Primary Care Clinic/Center
  • Mount Vernon, IL
  • NPI 1427366921
  Medicare reassignment NPD
• Premise Health of Illinois Medical PC

  dba Operator's Health Center

  • Multi-Specialty Clinic/Center
  • Countryside, IL
  • NPI 1083006001
  NPD
• Premise Health of Illinois Medical PC

  dba MCL Health Center - Utica

  • Multi-Specialty Clinic/Center
  • Utica, IL
  • NPI 1295518868
  NPD

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

{
    "created_epoch": "1526688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610409600000",
    "number": "1164913737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1118 JACKSON PL",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463111457",
            "telephone_number": "773-870-9079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1118 JACKSON PL",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463111457",
            "telephone_number": "773-870-9079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURRELL",
        "first_name": "ERIN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "PSY.D., HSPP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-19",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20042902A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jake S Brown, DPT
• Satara Brown, MD
• Erica L Bucholtz, OTR
• Jodi Bult, N.P.
• Tanya D Burk-Willson, RN
• C.L.O. Psychological, Serv.
• Timothy Caballero
• Cannan Healthcare Services & Staffing Inc
• Cardiospecialists Group, LTD (Midwest Arrhythmia Consultants)
• Bethany Lynn Casson, LMHC, LCPC

• Clinical Psychologist in Dyer, IN
• Providers in Dyer, IN by specialty
• Clinical Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2021; 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.

Verify at the official NPI Registry.