Provider Demographics
NPI:1528209863
Name:THOMAS TORRENCE, KISHA L (CASAC-T)
Entity Type:Individual
Prefix:
First Name:KISHA
Middle Name:L
Last Name:THOMAS TORRENCE
Suffix:
Gender:F
Credentials:CASAC-T
Other - Prefix:
Other - First Name:KISHA
Other - Middle Name:L
Other - Last Name:TORRENCE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CASAC-T
Mailing Address - Street 1:19 UNION SQ W
Mailing Address - Street 2:7TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-3304
Mailing Address - Country:US
Mailing Address - Phone:212-627-9600
Mailing Address - Fax:212-627-4040
Practice Address - Street 1:19 UNION SQ W
Practice Address - Street 2:7TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3304
Practice Address - Country:US
Practice Address - Phone:212-627-9600
Practice Address - Fax:212-627-4040
Is Sole Proprietor?:No
Enumeration Date:2009-03-17
Last Update Date:2009-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)