Provider Demographics
NPI:1477079739
Name:TORRES, WILFREDO E (LSW)
Entity Type:Individual
Prefix:
First Name:WILFREDO
Middle Name:E
Last Name:TORRES
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15957 FIVE POINT RD
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-9797
Mailing Address - Country:US
Mailing Address - Phone:330-234-0460
Mailing Address - Fax:
Practice Address - Street 1:30 NORTHWEST AVENUE
Practice Address - Street 2:BUILDING A, SUITE 120
Practice Address - City:TALLMADGE
Practice Address - State:OH
Practice Address - Zip Code:44278
Practice Address - Country:US
Practice Address - Phone:330-633-4187
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1700622104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker