MEDICARE: ALVARO HARICO ORDONEZ LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor
2	101YP2500X	Professional Counselor	LPC003322	GA

General Provider Information

NPI Number	:	1427725332
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALVARO HARICO ORDONEZ LPC

Provider Business Mailing Address
First Line	:	1000 JEFFERSON ST STE 2C
Second Line	:
City	:	LYNCHBURG
State	:	VA
Zip	:	24504-1724
Country	:	US
Telephone Number	:	855-284-7483
Fax Number	:	617-807-0958

Provider Business Practice Location Address
First Line	:	8800 ROSWELL RD STE A-135
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30350-1826
Country	:	US
Telephone Number	:	855-284-7483
Fax Number	:	617-807-0958

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/27/2021
Last Update Date	:	08/27/2021

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Directions to “ ALVARO HARICO ORDONEZ LPC” Practice Location

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