Provider Demographics
NPI:1215121157
Name:INGRAM, RAQUEL TORRES (LCSW)
Entity type:Individual
Prefix:MS
First Name:RAQUEL
Middle Name:TORRES
Last Name:INGRAM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:948 WOODLAND STREET
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37206
Mailing Address - Country:US
Mailing Address - Phone:615-485-4513
Mailing Address - Fax:615-650-8917
Practice Address - Street 1:948 WOODLAND STREET
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37206
Practice Address - Country:US
Practice Address - Phone:615-485-4513
Practice Address - Fax:615-650-8917
Is Sole Proprietor?:No
Enumeration Date:2007-09-04
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN31381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical