Provider Demographics
NPI:1841510815
Name:ALVAREZ, DONNA MATHENY (LPC, RPT)
Entity type:Individual
Prefix:MS
First Name:DONNA
Middle Name:MATHENY
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:LPC, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 S 5TH ST E
Mailing Address - Street 2:
Mailing Address - City:RIVERTON
Mailing Address - State:WY
Mailing Address - Zip Code:82501-4719
Mailing Address - Country:US
Mailing Address - Phone:307-670-8126
Mailing Address - Fax:
Practice Address - Street 1:414 S 5TH ST E
Practice Address - Street 2:
Practice Address - City:RIVERTON
Practice Address - State:WY
Practice Address - Zip Code:82501-4719
Practice Address - Country:US
Practice Address - Phone:307-670-8126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-01
Last Update Date:2010-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLPC-1105101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional