Provider Demographics
NPI:1457981003
Name:TORREZ, NAOMI (LPC)
Entity Type:Individual
Prefix:
First Name:NAOMI
Middle Name:
Last Name:TORREZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2005 W 14TH ST STE 134
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-6944
Mailing Address - Country:US
Mailing Address - Phone:480-798-4123
Mailing Address - Fax:
Practice Address - Street 1:2005 W 14TH ST STE 134
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-6944
Practice Address - Country:US
Practice Address - Phone:480-798-4123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-23
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAC-17399101YP2500X
AZLPC-19196101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZLAC-17399OtherLAC
AZLPC-19196OtherLPC