Provider Demographics
NPI:1467662973
Name:TORRES, MATILDE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MATILDE
Middle Name:
Last Name:TORRES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2840 W FULLERTON AVE
Mailing Address - Street 2:LOGAN SQUARE HEALTH CENTER OF COOK COUNTY
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60639
Mailing Address - Country:US
Mailing Address - Phone:773-395-2631
Mailing Address - Fax:773-395-9608
Practice Address - Street 1:2840 W FULLERTON AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-2938
Practice Address - Country:US
Practice Address - Phone:773-395-2631
Practice Address - Fax:773-395-9608
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149-0090261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical