Provider Demographics
NPI:1194154229
Name:TORRENCE, MARLA C (LCAS)
Entity type:Individual
Prefix:
First Name:MARLA
Middle Name:C
Last Name:TORRENCE
Suffix:
Gender:F
Credentials:LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 W 32ND ST
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27105-3653
Mailing Address - Country:US
Mailing Address - Phone:336-722-4000
Mailing Address - Fax:336-722-8003
Practice Address - Street 1:32 W 32ND ST
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27105-3653
Practice Address - Country:US
Practice Address - Phone:336-722-4000
Practice Address - Fax:336-722-8003
Is Sole Proprietor?:No
Enumeration Date:2013-11-08
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3377-A101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)