Provider Demographics
NPI:1851474456
Name:TORRES, LUZ IDALIA (LCSW)
Entity Type:Individual
Prefix:
First Name:LUZ
Middle Name:IDALIA
Last Name:TORRES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 LONG ISLAND AVE
Mailing Address - Street 2:
Mailing Address - City:HOLTSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11742-1822
Mailing Address - Country:US
Mailing Address - Phone:631-654-4977
Mailing Address - Fax:631-647-3130
Practice Address - Street 1:245 LONG ISLAND AVE
Practice Address - Street 2:
Practice Address - City:HOLTSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11742-1822
Practice Address - Country:US
Practice Address - Phone:631-654-4977
Practice Address - Fax:631-647-3130
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR064753-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN3P545Medicare ID - Type UnspecifiedMEDICARE