Provider Demographics
NPI:1679124432
Name:TORRES, LUIS ROBERTO (LMSW)
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:ROBERTO
Last Name:TORRES
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 AMSTERDAM AVE APT 10F
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-5136
Mailing Address - Country:US
Mailing Address - Phone:787-202-7422
Mailing Address - Fax:
Practice Address - Street 1:850 AMSTERDAM AVE APT 10F
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-5136
Practice Address - Country:US
Practice Address - Phone:787-202-7422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-24
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY103424104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker