Provider Demographics
NPI:1720414212
Name:TORRES, SHANIKA DE'VORIA (LPC)
Entity Type:Individual
Prefix:
First Name:SHANIKA
Middle Name:DE'VORIA
Last Name:TORRES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11903 DURAN CANYON LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77067-5217
Mailing Address - Country:US
Mailing Address - Phone:503-559-0843
Mailing Address - Fax:
Practice Address - Street 1:161 HIGH ST SE STE 251
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-3957
Practice Address - Country:US
Practice Address - Phone:503-559-0843
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-17
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC4648101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health