Provider Demographics
NPI:1326611567
Name:SHERRY-TORRES, TARA (LSW)
Entity Type:Individual
Prefix:
First Name:TARA
Middle Name:
Last Name:SHERRY-TORRES
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7212 SCHLEY CT
Mailing Address - Street 2:
Mailing Address - City:SWISSVALE
Mailing Address - State:PA
Mailing Address - Zip Code:15218-2441
Mailing Address - Country:US
Mailing Address - Phone:718-753-8657
Mailing Address - Fax:
Practice Address - Street 1:7212 SCHLEY CT
Practice Address - Street 2:
Practice Address - City:SWISSVALE
Practice Address - State:PA
Practice Address - Zip Code:15218-2441
Practice Address - Country:US
Practice Address - Phone:718-753-8657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-23
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW137208101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PASW137208Medicaid