Healthcare Provider Details

I. General information

NPI: 1063798734
Provider Name (Legal Business Name): MARYLOU TORRES LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/26/2011
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 CONEY ISLAND AVE 3RD FLOOR
BROOKLYN NY
11230-1313
US

IV. Provider business mailing address

131 SCOTT AVE APT 1
YONKERS NY
10704-4320
US

V. Phone/Fax

Practice location:
  • Phone: 718-434-1012
  • Fax: 718-434-1088
Mailing address:
  • Phone: 917-232-2819
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number072795-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: