Provider Demographics
NPI:1376777938
Name:TORRES, ANGEL LUIS (MSW, CAP)
Entity Type:Individual
Prefix:MR
First Name:ANGEL
Middle Name:LUIS
Last Name:TORRES
Suffix:
Gender:M
Credentials:MSW, CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4750 E MOODY BLVD STE 209
Mailing Address - Street 2:
Mailing Address - City:BUNNELL
Mailing Address - State:FL
Mailing Address - Zip Code:32110-7711
Mailing Address - Country:US
Mailing Address - Phone:386-338-8103
Mailing Address - Fax:
Practice Address - Street 1:4750 E MOODY BLVD STE 209
Practice Address - Street 2:
Practice Address - City:BUNNELL
Practice Address - State:FL
Practice Address - Zip Code:32110-7711
Practice Address - Country:US
Practice Address - Phone:386-338-8103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-12
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical