Provider Demographics
NPI:1548445125
Name:TORRES JOHNSON, TERESA R (LPC)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:R
Last Name:TORRES JOHNSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1144 NIAGARA HIEGHTS
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:TX
Mailing Address - Zip Code:76513-5669
Mailing Address - Country:US
Mailing Address - Phone:254-933-2372
Mailing Address - Fax:
Practice Address - Street 1:309 PIONEER TRL
Practice Address - Street 2:
Practice Address - City:HARKER HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:76548-5669
Practice Address - Country:US
Practice Address - Phone:254-699-2431
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-02
Last Update Date:2014-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11235101YA0400X
TX61743101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)