Provider Demographics
NPI:1205466299
Name:ALVAREZ, LORENA (LPCC, LPAT, ATR-BC)
Entity type:Individual
Prefix:
First Name:LORENA
Middle Name:
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:LPCC, LPAT, ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 YOUNG ST
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-3505
Mailing Address - Country:US
Mailing Address - Phone:561-376-1900
Mailing Address - Fax:
Practice Address - Street 1:1605 YOUNG ST
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-3505
Practice Address - Country:US
Practice Address - Phone:561-376-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-19
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCAT0188151221700000X
NMCCMH0191231101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM60425741Medicaid