Provider Demographics
NPI:1376977546
Name:ALVAREZ, MEGAN (LCPC)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:BLAZEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCPC
Mailing Address - Street 1:500 COVENTRY LN STE 130
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60014-7578
Mailing Address - Country:US
Mailing Address - Phone:815-889-0582
Mailing Address - Fax:
Practice Address - Street 1:500 COVENTRY LN STE 130
Practice Address - Street 2:
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-7578
Practice Address - Country:US
Practice Address - Phone:815-453-8966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-24
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180008739101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional