Provider Demographics
NPI:1508385758
Name:TORRENCE, SHAREN ANN
Entity Type:Individual
Prefix:
First Name:SHAREN
Middle Name:ANN
Last Name:TORRENCE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 CARPENTER DRIVE NE
Mailing Address - Street 2:400
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30328
Mailing Address - Country:US
Mailing Address - Phone:678-460-0345
Mailing Address - Fax:
Practice Address - Street 1:270 CARPENTER DRIVE NE
Practice Address - Street 2:400
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-3032
Practice Address - Country:US
Practice Address - Phone:678-460-0345
Practice Address - Fax:678-460-0345
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-19
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHTD747970OtherOHDL