Provider Demographics
NPI:1770984296
Name:TORRES, JABNEEL (MS, CAP)
Entity type:Individual
Prefix:
First Name:JABNEEL
Middle Name:
Last Name:TORRES
Suffix:
Gender:M
Credentials:MS, CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8359 BEACON BLVD STE 312
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-3062
Mailing Address - Country:US
Mailing Address - Phone:239-747-5791
Mailing Address - Fax:
Practice Address - Street 1:8359 BEACON BLVD STE 312
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-3062
Practice Address - Country:US
Practice Address - Phone:239-747-5701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-16
Last Update Date:2017-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
FLIMH16466101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)