Healthcare Provider Details

I. General information

NPI: 1831448109
Provider Name (Legal Business Name): VANESSA TORRES LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2012
Last Update Date: 11/03/2023
Certification Date: 11/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2050A 2ND ST SE
ALBUQUERQUE NM
87117-1224
US

IV. Provider business mailing address

7115 WESTON PL NW
ALBUQUERQUE NM
87114-3672
US

V. Phone/Fax

Practice location:
  • Phone: 505-846-3200
  • Fax:
Mailing address:
  • Phone: 505-393-9752
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC-09825
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: