Provider Demographics
NPI:1316471295
Name:TORREZ, NICOLAS (LCDC)
Entity type:Individual
Prefix:
First Name:NICOLAS
Middle Name:
Last Name:TORREZ
Suffix:
Gender:M
Credentials:LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3129 LAZY PALM DR N
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78552-4218
Mailing Address - Country:US
Mailing Address - Phone:956-536-8363
Mailing Address - Fax:956-230-1386
Practice Address - Street 1:3129 LAZY PALM DR N
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78552-4218
Practice Address - Country:US
Practice Address - Phone:956-536-8363
Practice Address - Fax:956-230-1386
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-17
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13874101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)