Provider Demographics
NPI:1235585373
Name:TORRES RIVERA, EDIL (LPC)
Entity Type:Individual
Prefix:DR
First Name:EDIL
Middle Name:
Last Name:TORRES RIVERA
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 GEORGE ST APT 115
Mailing Address - Street 2:
Mailing Address - City:BENSENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60106-3147
Mailing Address - Country:US
Mailing Address - Phone:352-505-8870
Mailing Address - Fax:
Practice Address - Street 1:120 GEORGE ST APT 115
Practice Address - Street 2:
Practice Address - City:BENSENVILLE
Practice Address - State:IL
Practice Address - Zip Code:60106-3147
Practice Address - Country:US
Practice Address - Phone:352-505-8870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-08
Last Update Date:2016-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2477101YP2500X
MI6401000688101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional