Provider Demographics
NPI:1124862248
Name:TORGERSON, AIDAN
Entity type:Individual
Prefix:
First Name:AIDAN
Middle Name:
Last Name:TORGERSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:694 JOHANNE PL APT B
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-6423
Mailing Address - Country:US
Mailing Address - Phone:719-304-4890
Mailing Address - Fax:
Practice Address - Street 1:660 SOUTHPOINTE CT STE 200
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-3874
Practice Address - Country:US
Practice Address - Phone:719-304-4890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health