Provider Demographics
NPI:1811641905
Name:TORRES, SERGIO JR (LMSW)
Entity type:Individual
Prefix:MR
First Name:SERGIO
Middle Name:
Last Name:TORRES
Suffix:JR
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3134 30TH ST APT 2R
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11106-2838
Mailing Address - Country:US
Mailing Address - Phone:917-202-7833
Mailing Address - Fax:
Practice Address - Street 1:240 E 123RD ST FL 3
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035-2050
Practice Address - Country:US
Practice Address - Phone:646-831-4736
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-08
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1151391041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool