Provider Demographics
NPI:1639604085
Name:ALVARE, CARLO (MED, ,LAC, NCC)
Entity Type:Individual
Prefix:
First Name:CARLO
Middle Name:
Last Name:ALVARE
Suffix:
Gender:M
Credentials:MED, ,LAC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-2504
Mailing Address - Country:US
Mailing Address - Phone:201-444-3550
Mailing Address - Fax:201-652-9164
Practice Address - Street 1:120 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-2504
Practice Address - Country:US
Practice Address - Phone:201-444-3550
Practice Address - Fax:201-652-9164
Is Sole Proprietor?:No
Enumeration Date:2017-04-24
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00172300101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health