Provider Demographics
NPI:1902081516
Name:TORRES, SERINA DENISE (MS)
Entity Type:Individual
Prefix:MS
First Name:SERINA
Middle Name:DENISE
Last Name:TORRES
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1802 HIGH BUTTE DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76905-8156
Mailing Address - Country:US
Mailing Address - Phone:325-450-3736
Mailing Address - Fax:
Practice Address - Street 1:133 W CONCHO AVE
Practice Address - Street 2:STE. 108
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76903-6449
Practice Address - Country:US
Practice Address - Phone:325-655-7549
Practice Address - Fax:325-655-0182
Is Sole Proprietor?:No
Enumeration Date:2008-01-02
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TC1900X
TX61022101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional