Provider Demographics
NPI:1083862221
Name:ARYA, SURESH C (LCSW)
Entity Type:Individual
Prefix:MR
First Name:SURESH
Middle Name:C
Last Name:ARYA
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 CARLTON CT
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-5830
Mailing Address - Country:US
Mailing Address - Phone:845-639-1617
Mailing Address - Fax:845-709-2216
Practice Address - Street 1:2 CARLTON CT
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-5830
Practice Address - Country:US
Practice Address - Phone:845-639-1617
Practice Address - Fax:845-709-2216
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-29
Last Update Date:2008-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR014936-1104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker