Provider Demographics
NPI:1346995115
Name:SURREY PSYCHOTHERAPY LCSW PLLC
Entity Type:Organization
Organization Name:SURREY PSYCHOTHERAPY LCSW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:OLAYA
Authorized Official - Last Name:COMPITUS
Authorized Official - Suffix:
Authorized Official - Credentials:DSW, LCSW
Authorized Official - Phone:917-301-0481
Mailing Address - Street 1:245 CONKLINGTOWN RD
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:NY
Mailing Address - Zip Code:10924-5603
Mailing Address - Country:US
Mailing Address - Phone:917-301-0481
Mailing Address - Fax:
Practice Address - Street 1:49 MAIN ST
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:NY
Practice Address - Zip Code:10918-1330
Practice Address - Country:US
Practice Address - Phone:845-533-5063
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-19
Last Update Date:2022-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty