Provider Demographics
NPI:1376748517
Name:ALVARADO, BRENDA LYNN (CLINICAL MENTAL HEAL)
Entity Type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:LYNN
Last Name:ALVARADO
Suffix:
Gender:F
Credentials:CLINICAL MENTAL HEAL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:311 NORTH AVE. Q
Mailing Address - Street 2:
Mailing Address - City:PORTALES
Mailing Address - State:NM
Mailing Address - Zip Code:88130
Mailing Address - Country:US
Mailing Address - Phone:575-607-7822
Mailing Address - Fax:575-935-2700
Practice Address - Street 1:208 EAST GRAND AVE. RIOVIDA COUNSELING
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:NM
Practice Address - Zip Code:88101
Practice Address - Country:US
Practice Address - Phone:505-762-9000
Practice Address - Fax:505-762-9009
Is Sole Proprietor?:No
Enumeration Date:2007-06-18
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0132781101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional