Provider Demographics
NPI:1093035214
Name:SURIEL, JELEN C (MHA)
Entity Type:Individual
Prefix:
First Name:JELEN
Middle Name:C
Last Name:SURIEL
Suffix:
Gender:F
Credentials:MHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 EMMONS AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-2209
Mailing Address - Country:US
Mailing Address - Phone:718-368-6291
Mailing Address - Fax:718-368-6290
Practice Address - Street 1:865 E 4TH ST
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18015-1935
Practice Address - Country:US
Practice Address - Phone:484-221-9136
Practice Address - Fax:484-221-9130
Is Sole Proprietor?:No
Enumeration Date:2010-06-10
Last Update Date:2012-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health