Provider Demographics
NPI:1528379377
Name:ALVAREZ, JULIE MARIE GIBSON (LCSW)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:MARIE GIBSON
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 EASTMORELAND AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-3555
Mailing Address - Country:US
Mailing Address - Phone:317-735-6126
Mailing Address - Fax:
Practice Address - Street 1:1325 EASTMORELAND AVE STE 150
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-3555
Practice Address - Country:US
Practice Address - Phone:317-735-6126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-27
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34006028A1041C0700X
TN75341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical