Provider Demographics
NPI:1720223878
Name:SCHURR, HENRY M (CSW/R)
Entity Type:Individual
Prefix:MR
First Name:HENRY
Middle Name:M
Last Name:SCHURR
Suffix:
Gender:M
Credentials:CSW/R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 VIXON CIR
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14903-7923
Mailing Address - Country:US
Mailing Address - Phone:607-562-7626
Mailing Address - Fax:
Practice Address - Street 1:14 VIXON CIR
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14903-7923
Practice Address - Country:US
Practice Address - Phone:607-562-7626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-03
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR012274-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY54794BMedicare PIN