Healthcare Provider Details

I. General information

NPI: 1831239813
Provider Name (Legal Business Name): CAROLYN TORRES LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 VAN WYCK EXPRESSWAY
JAMAICA NY
11418
US

IV. Provider business mailing address

27 THOMPSON ST.
VALLEY STREAM NY
11580
US

V. Phone/Fax

Practice location:
  • Phone: 718-206-6000
  • Fax: 718-206-7169
Mailing address:
  • Phone: 516-568-2729
  • Fax: 718-739-2993

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number073746-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: