Provider Demographics
NPI:1841906914
Name:ALVAREZ, SHANEEN D (LCSW)
Entity type:Individual
Prefix:
First Name:SHANEEN
Middle Name:D
Last Name:ALVAREZ
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 ARROWHEAD DR
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22556-1213
Mailing Address - Country:US
Mailing Address - Phone:410-705-0686
Mailing Address - Fax:
Practice Address - Street 1:3400 MLK JR AVE SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-1542
Practice Address - Country:US
Practice Address - Phone:202-724-7847
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-23
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500778071041C0700X
VA09040047851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty