Provider Demographics
NPI:1235696170
Name:ALVAREZ, SHAUNTA ADAMS (MS, LPCA, NCC)
Entity Type:Individual
Prefix:
First Name:SHAUNTA
Middle Name:ADAMS
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:MS, LPCA, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3367
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-0367
Mailing Address - Country:US
Mailing Address - Phone:336-270-3725
Mailing Address - Fax:
Practice Address - Street 1:350 HOLLY HILL LN STE A
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-5691
Practice Address - Country:US
Practice Address - Phone:844-562-2777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-27
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA14260101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health