Individual provider Active NPI

Mallika Chakrabarti, PHD, LP

  • Clinical Psychologist
  • Springfield, MO
National Provider Identifier
1477037505
Registry record updated Jun 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2023037873 Issued in MO
Practice address
1350 E Bradford Pkwy BLDG C
Springfield, MO 65804-4376
Phone
(417) 761-5000
NPI assigned
Sep 25, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2025

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 2023037873 MO Primary

Addresses

Primary practice location

1350 E Bradford Pkwy BLDG C
Springfield, MO 65804-4376

Mailing address

2885 W Battlefield St
Springfield, MO 65807-3952
Phone (417) 761-5214

Other identifiers 1

IdentifierTypeStateIssuer
490063111MedicaidMO

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
I20241120002971 MO Practitioner - Clinical Psychologist 3072048560 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Burrell IncGroup PAC ID 4486548625, 217 clinicians

Practice addresses (Care Compare)

1350 E Bradford Pkwy
Burrell Behavioral Health
Springfield, MO 65804-4376
Phone (417) 761-5850

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2023037873MOMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Burrell, Inc. CurrentSince Oct 21, 2024 Accepting new patients
Burrell, Inc. CurrentSince Oct 21, 2024 Accepting new patients

Locations

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

1350 E Bradford Pkwy
Springfield, MO 65804
Phone (417) 597-4309

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

1350 E Bradford Pkwy
Bldg C
Springfield, MO 65804
Phone (417) 761-5850

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": "1537833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1477037505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2885 W BATTLEFIELD ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658073952",
            "telephone_number": "417-761-5214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 E BRADFORD PKWY BLDG C",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658044376",
            "telephone_number": "417-761-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAKRABARTI",
        "first_name": "MALLIKA",
        "credential": "PHD, LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-25",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "2023037873",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "490063111",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.