MEDICARE: MS. MELISSA 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	104100000X	Social Worker	078519	NY
2	1041C0700X	Clinical Social Worker	0904011528	VA

General Provider Information

NPI Number	:	1902119597
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MELISSA TORRES LCSW

Provider Business Mailing Address
First Line	:	307 LAFAYETTE BLVD STE 300
Second Line	:
City	:	FREDERICKSBURG
State	:	VA
Zip	:	22401-6066
Country	:	US
Telephone Number	:	540-907-0991
Fax Number	:

Provider Business Practice Location Address
First Line	:	307 LAFAYETTE BLVD STE 300
Second Line	:
City	:	FREDERICKSBURG
State	:	VA
Zip	:	22401-6066
Country	:	US
Telephone Number	:	540-907-0991
Fax Number	:

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

Provider Enumeration Date	:	07/23/2010
Last Update Date	:	05/19/2020

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