Provider Demographics
NPI:1316220635
Name:TORRES, ANDREA JEAN (MSW)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:JEAN
Last Name:TORRES
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 DEEPWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06074-2907
Mailing Address - Country:US
Mailing Address - Phone:860-212-6513
Mailing Address - Fax:
Practice Address - Street 1:132 MANSFIELD AVE
Practice Address - Street 2:SUITE #200
Practice Address - City:WILLIMANTIC
Practice Address - State:CT
Practice Address - Zip Code:06226-2033
Practice Address - Country:US
Practice Address - Phone:860-456-2261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-22
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004040564Medicaid