Provider Demographics
NPI:1619706330
Name:TORRELLAS, JENNIFER B (CASAC-T)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:B
Last Name:TORRELLAS
Suffix:
Gender:F
Credentials:CASAC-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6888 PLAZA DR APT 4
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14304-6535
Mailing Address - Country:US
Mailing Address - Phone:716-730-1968
Mailing Address - Fax:
Practice Address - Street 1:800 MAIN ST STE 2A
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14301-1156
Practice Address - Country:US
Practice Address - Phone:716-282-1228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-31
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)