Provider Demographics
NPI:1083705404
Name:TORRES, ELLEN KAY (LCSW)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:KAY
Last Name:TORRES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KAY
Other - Middle Name:
Other - Last Name:TORRES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:5606 N NAVARRO ST
Mailing Address - Street 2:#200
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77904-1727
Mailing Address - Country:US
Mailing Address - Phone:361-575-0569
Mailing Address - Fax:361-575-5235
Practice Address - Street 1:5606 N NAVARRO ST
Practice Address - Street 2:#200
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77904-1727
Practice Address - Country:US
Practice Address - Phone:361-575-0569
Practice Address - Fax:361-575-5235
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX061111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical