Provider Demographics
NPI:1154787331
Name:TORRES, CLIVIA M
Entity type:Individual
Prefix:MS
First Name:CLIVIA
Middle Name:M
Last Name:TORRES
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:CLIVIA
Other - Middle Name:M
Other - Last Name:TORRES-LACEND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:221 E 106TH ST APT 2B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-4060
Mailing Address - Country:US
Mailing Address - Phone:646-425-8988
Mailing Address - Fax:212-987-1922
Practice Address - Street 1:221 E 106TH ST APT 2B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-4060
Practice Address - Country:US
Practice Address - Phone:646-425-8988
Practice Address - Fax:212-987-1922
Is Sole Proprietor?:No
Enumeration Date:2016-01-04
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR05462211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical