Provider Demographics
NPI:1891286050
Name:ALVAREZ, LYANNA (LMHC)
Entity Type:Individual
Prefix:
First Name:LYANNA
Middle Name:
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5151 ADANSON ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-1317
Mailing Address - Country:US
Mailing Address - Phone:407-875-3700
Mailing Address - Fax:
Practice Address - Street 1:1800 MERCY DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32808-5646
Practice Address - Country:US
Practice Address - Phone:407-875-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-23
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
FLMH23128101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1134107113OtherMBHP
MA12529OtherHNE
MA1134107113OtherNHP
MAY10086OtherMEDICARE
MA042622756OtherCCA
MA1134107113OtherFALLON
MA1134107113OtherBEACON
MA997303OtherNETWORK HEALTH
MA1134107113Medicaid
MA71756OtherTUFTS