Provider Demographics
NPI:1659467967
Name:TORRES, GERARDO (MA)
Entity type:Individual
Prefix:
First Name:GERARDO
Middle Name:
Last Name:TORRES
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 MARSHALL ST
Mailing Address - Street 2:
Mailing Address - City:NORTH ADAMS
Mailing Address - State:MA
Mailing Address - Zip Code:01247-2451
Mailing Address - Country:US
Mailing Address - Phone:413-664-4541
Mailing Address - Fax:
Practice Address - Street 1:25 MARSHALL ST
Practice Address - Street 2:
Practice Address - City:NORTH ADAMS
Practice Address - State:MA
Practice Address - Zip Code:01247-2451
Practice Address - Country:US
Practice Address - Phone:413-664-4541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8987103TC0700X
VT48.0061308103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical