MEDICARE: ALVARADO PSYCHOTHERAPY INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	1041C0700X	Clinical Social Worker
2	106H00000X	Marriage & Family Therapist
3	101YP2500X	Professional Counselor
4	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1811583800
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALVARADO PSYCHOTHERAPY INC

Provider Business Mailing Address
First Line	:	2219 MAIN ST STE 335
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90405-2217
Country	:	US
Telephone Number	:	323-250-2449
Fax Number	:

Provider Business Practice Location Address
First Line	:	2219 MAIN ST STE 335
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90405-2217
Country	:	US
Telephone Number	:	323-250-2449
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER/DIRECTOR
Name	:	PATRICIA ALVARADO
Credential	:	MA, LPCC, LMHC
Telephone Number	:	323-250-2449

Provider Enumeration Date	:	12/14/2020
Last Update Date	:	12/14/2020

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