Provider Demographics
NPI:1265713366
Name:TORRES, REBECCA MONICA (EDS, NCSP, LMHC)
Entity type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:MONICA
Last Name:TORRES
Suffix:
Gender:F
Credentials:EDS, NCSP, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 856
Mailing Address - Street 2:
Mailing Address - City:RUIDOSO
Mailing Address - State:NM
Mailing Address - Zip Code:88355-0856
Mailing Address - Country:US
Mailing Address - Phone:575-635-7050
Mailing Address - Fax:
Practice Address - Street 1:1096 MECHEM DR STE 209
Practice Address - Street 2:
Practice Address - City:RUIDOSO
Practice Address - State:NM
Practice Address - Zip Code:88345-7068
Practice Address - Country:US
Practice Address - Phone:575-635-7050
Practice Address - Fax:505-212-0554
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-01
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM337836103TS0200X
NMCMH0217351103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool