Provider Demographics
NPI:1033856836
Name:TORRES, SHADDIA WILKINS (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SHADDIA
Middle Name:WILKINS
Last Name:TORRES
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 1:417 MYRTLE AVE # 1028
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11205-2426
Mailing Address - Country:US
Mailing Address - Phone:252-251-6107
Mailing Address - Fax:
Practice Address - Street 1:417 MYRTLE AVE # 1028
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11205-2426
Practice Address - Country:US
Practice Address - Phone:252-251-6107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-13
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0818011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical