Provider Demographics
NPI:1366846800
Name:TORRES, DEBRA (LCPC, CADC)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:
Last Name:TORRES
Suffix:
Gender:F
Credentials:LCPC, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1680 W GLENN AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62704-4825
Mailing Address - Country:US
Mailing Address - Phone:217-361-8093
Mailing Address - Fax:217-698-1125
Practice Address - Street 1:801 S GRAND AVE W
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62704-3666
Practice Address - Country:US
Practice Address - Phone:217-361-8093
Practice Address - Fax:217-698-1125
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-13
Last Update Date:2016-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.008477101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional