Provider Demographics
NPI:1164849659
Name:TORRES, TABATHA VANESSA (MSW, LICSW, LCSW)
Entity Type:Individual
Prefix:
First Name:TABATHA
Middle Name:VANESSA
Last Name:TORRES
Suffix:
Gender:F
Credentials:MSW, LICSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 CINDY LN
Mailing Address - Street 2:
Mailing Address - City:CAPITOL HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20743-2710
Mailing Address - Country:US
Mailing Address - Phone:202-420-0109
Mailing Address - Fax:
Practice Address - Street 1:6 CINDY LN
Practice Address - Street 2:
Practice Address - City:CAPITOL HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20743-2710
Practice Address - Country:US
Practice Address - Phone:202-420-0109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-24
Last Update Date:2022-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500816001041C0700X
VA09040115931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical