Healthcare Provider Details

I. General information

NPI: 1053696054
Provider Name (Legal Business Name): JOHN M. TORRES-GREKLEK LMSW,CASAC-M
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/21/2011
Last Update Date: 08/01/2024
Certification Date: 08/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 7TH AVE
TROY NY
12180-3410
US

IV. Provider business mailing address

RENSSLAER COUNTY MENTAL HEALTH, 1600 7TH AVENUE, 3RD FL
RENSSLAER NY
12180
US

V. Phone/Fax

Practice location:
  • Phone: 518-270-2800
  • Fax:
Mailing address:
  • Phone: 518-270-2800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number10278
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number112312-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: