Basic Information
Provider Information
NPI: 1750795522
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TORRES
FirstName: SONIA
MiddleName: ALICIA
NamePrefix:  
NameSuffix:  
Credential: MSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: TORRES
OtherFirstName: SONIA
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 4340 E KENTUCKY AVE STE 365
Address2:  
City: GLENDALE
State: CO
PostalCode: 802462075
CountryCode: US
TelephoneNumber: 7202808781
FaxNumber: 3032864589
Practice Location
Address1: 6255 QUEBEC PKWY
Address2:  
City: COMMERCE CITY
State: CO
PostalCode: 80022
CountryCode: US
TelephoneNumber: 3032868900
FaxNumber: 3032866755
Other Information
ProviderEnumerationDate: 06/19/2014
LastUpdateDate: 01/23/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/20/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X  Y Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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