Provider Demographics
NPI:1871901462
Name:TORRELL, KERRY ANN (PHD)
Entity type:Individual
Prefix:DR
First Name:KERRY
Middle Name:ANN
Last Name:TORRELL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:358 VETERANS MEMORIAL HWY
Mailing Address - Street 2:SUITE 10
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-4326
Mailing Address - Country:US
Mailing Address - Phone:631-848-8526
Mailing Address - Fax:
Practice Address - Street 1:358 VETERANS MEMORIAL HWY
Practice Address - Street 2:SUITE 10
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-4326
Practice Address - Country:US
Practice Address - Phone:631-848-8526
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-27
Last Update Date:2016-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020414103TB0200X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral