Provider Demographics
NPI:1902990526
Name:URREA, DORIS (LCSW)
Entity Type:Individual
Prefix:
First Name:DORIS
Middle Name:
Last Name:URREA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 EAST 36TH STREET APT 17-G
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016
Mailing Address - Country:US
Mailing Address - Phone:718-478-1526
Mailing Address - Fax:718-429-0738
Practice Address - Street 1:37-20 76TH STREET
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372
Practice Address - Country:US
Practice Address - Phone:718-478-1526
Practice Address - Fax:718-429-0738
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR034058-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY181033OtherELDERPLAN
NYR034058-A37OtherHEALTHFIRST
NYP3178509OtherOXFORD HEALTH PLAN
NY181033OtherELDERPLAN
NYR27949Medicare UPIN