=====================================================
General NPI Number Information
=====================================================
NPI Number | 1659931640
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TORRESY SMITH LPC, LCDC-I
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/20/2019
-----------------------------------------------------
Last Update Date | 06/20/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 12301 MAIN ST
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77035-6207
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-275-5202
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2618 SKYVIEW GLEN CT
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77047-6818
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 979-398-9110
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 73926
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------