Provider Demographics
NPI:1962817627
Name:MARES, ALVIN (PHD)
Entity Type:Individual
Prefix:
First Name:ALVIN
Middle Name:
Last Name:MARES
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:628 COMMANCHE RD
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-1215
Mailing Address - Country:US
Mailing Address - Phone:740-804-6800
Mailing Address - Fax:740-721-4155
Practice Address - Street 1:628 COMMANCHE RD
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-1215
Practice Address - Country:US
Practice Address - Phone:740-804-6800
Practice Address - Fax:740-721-4155
Is Sole Proprietor?:No
Enumeration Date:2014-06-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI16006821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical