Provider Demographics
NPI:1467535047
Name:TORRES, BELINDA J (PHD)
Entity Type:Individual
Prefix:
First Name:BELINDA
Middle Name:J
Last Name:TORRES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9614 OLD JOHNNYCAKE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-6521
Mailing Address - Country:US
Mailing Address - Phone:440-358-1159
Mailing Address - Fax:
Practice Address - Street 1:9614 OLD JOHNNYCAKE RIDGE RD
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-6521
Practice Address - Country:US
Practice Address - Phone:440-358-1159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2009-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5109103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2048528Medicaid
OHTOCP20533Medicare PIN