Provider Demographics
NPI:1013627447
Name:TORRES, CARRIE A (LPC-IT)
Entity Type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:A
Last Name:TORRES
Suffix:
Gender:F
Credentials:LPC-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3205 S 9TH PL
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53215-4728
Mailing Address - Country:US
Mailing Address - Phone:414-216-7429
Mailing Address - Fax:
Practice Address - Street 1:3205 S. 9TH PLACE
Practice Address - Street 2:STREET ADDRESS 2
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53215-4728
Practice Address - Country:US
Practice Address - Phone:414-216-7429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5395-226101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health