Provider Demographics
NPI:1932805256
Name:SURPASS COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:SURPASS COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:BERNARD
Authorized Official - Last Name:LYGA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:406-270-5713
Mailing Address - Street 1:PO BOX 6
Mailing Address - Street 2:
Mailing Address - City:PLAINS
Mailing Address - State:MT
Mailing Address - Zip Code:59859-0006
Mailing Address - Country:US
Mailing Address - Phone:406-270-5713
Mailing Address - Fax:
Practice Address - Street 1:2504 TRADEWINDS WAY
Practice Address - Street 2:
Practice Address - City:THOMPSON FALLS
Practice Address - State:MT
Practice Address - Zip Code:59873-9707
Practice Address - Country:US
Practice Address - Phone:406-270-5713
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-07
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty