Provider Demographics
NPI:1598957383
Name:ALVES, JOSEPHINE A (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JOSEPHINE
Middle Name:A
Last Name:ALVES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:JO
Other - Middle Name:ANN
Other - Last Name:ALVES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:404 S CLAY AVE
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63122-5808
Mailing Address - Country:US
Mailing Address - Phone:314-821-5521
Mailing Address - Fax:
Practice Address - Street 1:404 S CLAY AVE
Practice Address - Street 2:
Practice Address - City:ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63122-5808
Practice Address - Country:US
Practice Address - Phone:314-821-5521
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-15
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0018301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
11548256OtherCAQH