Healthcare Provider Details

I. General information

NPI: 1124862248
Provider Name (Legal Business Name): AIDAN TORGERSON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2024
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

655 S SIERRA MADRE ST APT 222
COLORADO SPRINGS CO
80903-4191
US

IV. Provider business mailing address

655 S SIERRA MADRE ST APT 222
COLORADO SPRINGS CO
80903-4191
US

V. Phone/Fax

Practice location:
  • Phone: 719-304-4890
  • Fax:
Mailing address:
  • Phone: 719-304-4890
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW.09933249
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: