Provider Demographics
NPI:1891165916
Name:SANTOS TORRES, LUIS
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:
Last Name:SANTOS TORRES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:995 WORTHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01109-4027
Mailing Address - Country:US
Mailing Address - Phone:413-734-5376
Mailing Address - Fax:
Practice Address - Street 1:995 WORTHINGTON ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01109-4027
Practice Address - Country:US
Practice Address - Phone:413-734-5376
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1303295Medicaid
MAM18463OtherBLUE CROSS BLUE SHIELD
MA1307576Medicaid
MA1303295Medicaid