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NPI Code Detail

MEDICARE: MS. TERRY SURINSKY LCSW

MEDICARE: MS. TERRY SURINSKY LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker002762MO
21041C0700XClinical Social Worker60937CA

General Provider Information

NPI Number : 1740382241
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. TERRY SURINSKY LCSW
Provider Business Mailing Address
First Line : 5060 SHOREHAM PL STE 330
Second Line :
City : SAN DIEGO
State : CA
Zip : 92122-5976
Country : US
Telephone Number : 866-657-6592
Fax Number :
Provider Business Practice Location Address
First Line : 5060 SHOREHAM PL STE 330
Second Line :
City : SAN DIEGO
State : CA
Zip : 92122-5976
Country : US
Telephone Number : 866-657-6592
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/04/2006
Last Update Date : 02/13/2023

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