Provider Demographics
NPI:1013679463
Name:CHINEA-ALVARADO, FABIOLA ANDREA (MS, NCC, LPC)
Entity Type:Individual
Prefix:
First Name:FABIOLA
Middle Name:ANDREA
Last Name:CHINEA-ALVARADO
Suffix:
Gender:F
Credentials:MS, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11012 CAIRNHILL CT
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78754-2162
Mailing Address - Country:US
Mailing Address - Phone:361-218-3535
Mailing Address - Fax:
Practice Address - Street 1:1221 ABRAMS RD
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-5578
Practice Address - Country:US
Practice Address - Phone:972-639-7199
Practice Address - Fax:214-593-4786
Is Sole Proprietor?:No
Enumeration Date:2021-10-12
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81730101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX81730OtherTEXAS BEHAVIORAL HEALTH EXECUTIVE COUNSEL