Provider Demographics
NPI:1689337495
Name:TORCASO, CARLY M (LSW)
Entity Type:Individual
Prefix:
First Name:CARLY
Middle Name:M
Last Name:TORCASO
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29133 HEALTH CAMPUS DR
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-5256
Mailing Address - Country:US
Mailing Address - Phone:440-835-6212
Mailing Address - Fax:
Practice Address - Street 1:29133 HEALTH CAMPUS DR
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-5256
Practice Address - Country:US
Practice Address - Phone:440-835-6212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-19
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.19040781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical