Provider Demographics
NPI:1750692711
Name:ALVARENGA, MARIANELA B (LAC, CCGC)
Entity type:Individual
Prefix:MRS
First Name:MARIANELA
Middle Name:B
Last Name:ALVARENGA
Suffix:
Gender:F
Credentials:LAC, CCGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1506 WILLIAMS BLVD
Mailing Address - Street 2:
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70062-6512
Mailing Address - Country:US
Mailing Address - Phone:504-471-2700
Mailing Address - Fax:504-471-2845
Practice Address - Street 1:1506 WILLIAMS BLVD
Practice Address - Street 2:
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70062-6512
Practice Address - Country:US
Practice Address - Phone:504-471-2700
Practice Address - Fax:504-471-2845
Is Sole Proprietor?:No
Enumeration Date:2010-06-24
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA899 & 133101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)