Healthcare Provider Details

I. General information

NPI: 1598320293
Provider Name (Legal Business Name): LEANA TORREZ LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2019
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1860 SW FOUNTAINVIEW BLVD STE 100
PORT ST LUCIE FL
34986-4528
US

IV. Provider business mailing address

1860 SW FOUNTAINVIEW BLVD STE 100
PORT ST LUCIE FL
34986-4528
US

V. Phone/Fax

Practice location:
  • Phone: 772-202-0517
  • Fax: 772-365-0929
Mailing address:
  • Phone: 772-202-0517
  • Fax: 772-365-0929

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH17081
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: