Healthcare Provider Details

I. General information

NPI: 1154582609
Provider Name (Legal Business Name): JULIE M TORRENCE LCSW, P.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2008
Last Update Date: 08/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1609 SHERMAN AVE SUITE 207
EVANSTON IL
60201-3753
US

IV. Provider business mailing address

1609 SHERMAN AVE SUITE 207
EVANSTON IL
60201-3753
US

V. Phone/Fax

Practice location:
  • Phone: 847-899-9079
  • Fax:
Mailing address:
  • Phone: 847-899-9079
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149014426
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number056004026
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: