Individual provider Active NPI

Keyshla Marie Colon Torres, LCSWA

  • Clinical Social Worker
  • Sanford, NC
National Provider Identifier
1770030173
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
130 Carbonton Rd
Sanford, NC 27330-4009
Phone
(787) 579-6831
NPI assigned
Sep 2, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 13383 PR
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

130 Carbonton Rd
Sanford, NC 27330-4009

Mailing address

675 Ponderosa TRL
Cameron, NC 28326-9745
Phone (787) 579-6831

Other practice location 1

731 Tilghman Dr
Dunn, NC 28334-5507
Phone (910) 249-4219

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250523000683 NC Practitioner - Clinical Social Worker 3971022872 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Daymark Recovery Services IncGroup PAC ID 0547233975, 132 clinicians

Practice addresses (Care Compare)

130 Carbonton Rd
Sanford, NC 27330-4009
Phone (919) 774-6521

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13383PRMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Daymark Recovery Services, Inc. Social Worker CurrentSince Mar 13, 2025 Accepting new patients
Tricare Counseling & Consulting, Inc. PastSince May 15, 2011 Accepting new patients

Locations

284 Executive Park Dr
Ste 100
Kannapolis, NC 28025
Phone (704) 939-1118

1104A S Main St
Lexington, NC 27292
Phone (336) 300-8836

2129 Statesville Blvd
Salisbury, NC 28147
Phone (704) 633-3616

130 Carbonton Rd
Sanford, NC 27330
Phone (919) 774-6521

Interoperability endpoints

  • Direct secure messaging: keyshlam.colntorres.p1@direct.daymarkrecovery.nextgenshare.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1472774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1770030173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 PONDEROSA TRL",
            "city": "CAMERON",
            "state": "NC",
            "postal_code": "283269745",
            "telephone_number": "787-579-6831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 CARBONTON RD",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273304009",
            "telephone_number": "787-579-6831"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "731 Tilghman Dr",
            "address_purpose": "LOCATION",
            "city": "Dunn",
            "state": "NC",
            "postal_code": "283345507",
            "country_code": "US",
            "telephone_number": "910-249-4219",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLON TORRES",
        "first_name": "KEYSHLA",
        "middle_name": "MARIE",
        "credential": "LCSWA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-02",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PR",
            "license": "13383",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sanford, NC

Sources for this page

Verify at the official NPI Registry.