Healthcare Provider Details

I. General information

NPI: 1184269763
Provider Name (Legal Business Name): TORRES-VEGA COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2019
Last Update Date: 09/22/2021
Certification Date: 09/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

863 TURNPIKE STREET SUITE 122/124
NORTH ANDOVER MA
01845
US

IV. Provider business mailing address

863 TURNPIKE STREET SUITE 122/124
NORTH ANDOVER MA
01845
US

V. Phone/Fax

Practice location:
  • Phone: 978-238-0936
  • Fax: 978-427-6493
Mailing address:
  • Phone: 978-238-0936
  • Fax: 978-427-6493

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: VICTORIA CARTER
Title or Position: PSYCHOTHERAPIST
Credential: LICSW
Phone: 978-238-0936