MEDICARE: AMNERIS JENICE TORRES LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	009624	CT
2	103TF0000X	Family Psychologist	009624	CT
3	103TP2701X	Group Psychotherapy Psychologist	009624	CT
4	1041C0700X	Clinical Social Worker	009624	CT

General Provider Information

NPI Number	:	1144566597
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMNERIS JENICE TORRES LCSW

Provider Business Mailing Address
First Line	:	282 WASHINGTON ST
Second Line	:
City	:	HARTFORD
State	:	CT
Zip	:	06106-3322
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1100 NEW BRITAIN AVE STE 201
Second Line	:
City	:	WEST HARTFORD
State	:	CT
Zip	:	06110-2447
Country	:	US
Telephone Number	:	860-970-8639
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/12/2012
Last Update Date	:	03/17/2018

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