Provider Demographics
NPI:1871461871
Name:ALIVIO AND WELLNESS LICENSED CLINICAL SOCIAL WORKER GROUP INC.
Entity type:Organization
Organization Name:ALIVIO AND WELLNESS LICENSED CLINICAL SOCIAL WORKER GROUP INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MAYRA
Authorized Official - Middle Name:LOURDES
Authorized Official - Last Name:ZAMORA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:805-295-4877
Mailing Address - Street 1:PO BOX 1081
Mailing Address - Street 2:
Mailing Address - City:NIPOMO
Mailing Address - State:CA
Mailing Address - Zip Code:93444-1081
Mailing Address - Country:US
Mailing Address - Phone:805-295-4877
Mailing Address - Fax:
Practice Address - Street 1:201 S MILLER ST STE 107
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-5248
Practice Address - Country:US
Practice Address - Phone:805-295-4877
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-29
Last Update Date:2025-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty