Provider Demographics
NPI:1093828592
Name:TORRES, ENRIQUE (LPC, LMFT, NCC)
Entity Type:Individual
Prefix:
First Name:ENRIQUE
Middle Name:
Last Name:TORRES
Suffix:
Gender:M
Credentials:LPC, LMFT, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 E MOCKINGBIRD LN
Mailing Address - Street 2:SUITE 262
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77904-2139
Mailing Address - Country:US
Mailing Address - Phone:361-575-0569
Mailing Address - Fax:361-575-5235
Practice Address - Street 1:1501 E MOCKINGBIRD LN
Practice Address - Street 2:SUITE 262
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77904-2139
Practice Address - Country:US
Practice Address - Phone:361-575-0569
Practice Address - Fax:361-575-5235
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11532101YM0800X
TX003092-042952106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX019200OtherVALUE OPTIONS ID
TX173554OtherCOMP PSYCH
TX2386LCOtherBLUE CROSS BLUE SHIELD