Provider Demographics
NPI:1508598616
Name:TORRES, PATRINA MELISSAN
Entity Type:Individual
Prefix:MRS
First Name:PATRINA
Middle Name:MELISSAN
Last Name:TORRES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 2421
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12402
Mailing Address - Country:US
Mailing Address - Phone:845-853-3884
Mailing Address - Fax:
Practice Address - Street 1:60 STAPLES STREET
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401
Practice Address - Country:US
Practice Address - Phone:845-853-3884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-28
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 101YA0400X, 102X00000X, 106S00000X, 171400000X, 172V00000X, 1744G0900X, 1744R1102X, 305S00000X
FL13108101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No102X00000XBehavioral Health & Social Service ProvidersPoetry Therapist
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No171400000XOther Service ProvidersHealth & Wellness Coach
No172V00000XOther Service ProvidersCommunity Health Worker
No1744G0900XOther Service ProvidersSpecialistGraphics Designer
No1744R1102XOther Service ProvidersSpecialistResearch Study
No305S00000XManaged Care OrganizationsPoint of Service