Healthcare Provider Details

I. General information

NPI: 1376321166
Provider Name (Legal Business Name): CLAREXI CUEVAS TORRES LCSW-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2023
Last Update Date: 07/15/2024
Certification Date: 09/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 BILLINGSLEY RD STE B
CHARLOTTE NC
28211-1009
US

IV. Provider business mailing address

PO BOX 19305
CHARLOTTE NC
28219-9305
US

V. Phone/Fax

Practice location:
  • Phone: 704-444-2400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP019750
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: