Courage Compass Therapy

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW017160 Issued in PA

Legal business name

COURAGE COMPASS THERAPY

Practice address

208 Easton Rd
Willow Grove, PA 19090-3205

Phone

(267) 209-0795

Fax

(844) 520-6984

NPI assigned

Jul 26, 2017

Last updated

Oct 27, 2017By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Anya L Surnitsky, LCSWNPI 1306107974

Title

Sole Owner

Phone

(215) 500-7470

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Anya Surnitsky, LCSW

  • Clinical Social Worker
  • Willow Grove, PA
  • NPI 1306107974
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1501027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509062400000",
    "number": "1437673027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 IVYSTREAM RD",
            "city": "HATBORO",
            "state": "PA",
            "postal_code": "190403012",
            "telephone_number": "215-500-7470",
            "fax_number": "844-520-6984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 EASTON RD",
            "city": "WILLOW GROVE",
            "state": "PA",
            "postal_code": "190903205",
            "telephone_number": "267-209-0795",
            "fax_number": "844-520-6984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COURAGE COMPASS THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-26",
        "last_updated": "2017-10-27",
        "status": "A",
        "authorized_official_last_name": "SURNITSKY",
        "authorized_official_first_name": "ANYA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "215-500-7470",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW017160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Willow Grove, PA
• Providers in Willow Grove, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.