Provider Demographics
NPI:1205277860
Name:TORRES, BEVERLY (LCSW)
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:
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 1:42 GUY LOMBARDO AVE STE 210C
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11520-3610
Mailing Address - Country:US
Mailing Address - Phone:516-331-2420
Mailing Address - Fax:
Practice Address - Street 1:42 GUY LOMBARDO AVE STE 210C
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:NY
Practice Address - Zip Code:11520-3610
Practice Address - Country:US
Practice Address - Phone:516-331-2420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-11
Last Update Date:2020-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1041S0200X
NY0884751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool