Provider Demographics
NPI:1871219998
Name:TORRES-CALCAGNO, VIVIANA IRIS (LPC, ATR)
Entity type:Individual
Prefix:MISS
First Name:VIVIANA
Middle Name:IRIS
Last Name:TORRES-CALCAGNO
Suffix:
Gender:F
Credentials:LPC, ATR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 MAIN ST # 2D
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457-3375
Mailing Address - Country:US
Mailing Address - Phone:203-248-6102
Mailing Address - Fax:
Practice Address - Street 1:360 MAIN ST STE 2D
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457-3375
Practice Address - Country:US
Practice Address - Phone:186-024-8604
Practice Address - Fax:184-426-4023
Is Sole Proprietor?:No
Enumeration Date:2022-10-19
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT22-290221700000X
CT46.005881101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist