Provider Demographics
NPI:1770543449
Name:SURHIO, AZRA NAHEED (LCSW)
Entity type:Individual
Prefix:MS
First Name:AZRA
Middle Name:NAHEED
Last Name:SURHIO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:AZRA
Other - Middle Name:
Other - Last Name:SURHIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:405 PLEASANT VIEW CIR
Mailing Address - Street 2:
Mailing Address - City:BLACKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24060-4008
Mailing Address - Country:US
Mailing Address - Phone:540-629-1118
Mailing Address - Fax:
Practice Address - Street 1:1970 ROANOKE BLVD
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-6404
Practice Address - Country:US
Practice Address - Phone:540-982-2463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-25
Last Update Date:2016-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0904003404104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
2041049OtherCIGNA
283944OtherTRIGON
082880OtherSENTARA
VA8918058Medicaid
234197000OtherMAGELLAN
515821OtherVALUE OPTIONS
540903278016OtherCARILION