Provider Demographics
NPI:1780494336
Name:ALVAREZ, LORENA (LMSW)
Entity type:Individual
Prefix:MISS
First Name:LORENA
Middle Name:
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 3RD ST
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83401-3953
Mailing Address - Country:US
Mailing Address - Phone:208-529-0169
Mailing Address - Fax:208-542-5152
Practice Address - Street 1:560 3RD ST
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83401-3953
Practice Address - Country:US
Practice Address - Phone:208-529-0169
Practice Address - Fax:208-542-5152
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-07
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID441681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical