Provider Demographics
NPI:1083103758
Name:TORRES, ANGELIQUE (MSW)
Entity Type:Individual
Prefix:
First Name:ANGELIQUE
Middle Name:
Last Name:TORRES
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:ANGELIQUE
Other - Middle Name:
Other - Last Name:BAC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:PO BOX 27258
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87125-7258
Mailing Address - Country:US
Mailing Address - Phone:505-764-8231
Mailing Address - Fax:505-248-1351
Practice Address - Street 1:8100 RAINBOW BLVD NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-6090
Practice Address - Country:US
Practice Address - Phone:505-890-0343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-08
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
NMSWB-2022-11671041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No171M00000XOther Service ProvidersCase Manager/Care Coordinator