Healthcare Provider Details

I. General information

NPI: 1538730700
Provider Name (Legal Business Name): EMILIE ALVAREZ LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2021
Last Update Date: 03/17/2026
Certification Date: 03/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 BREWSTER RD
BRISTOL CT
06010-5141
US

IV. Provider business mailing address

39A GRANDVIEW DR
FARMINGTON CT
06032-1305
US

V. Phone/Fax

Practice location:
  • Phone: 860-585-3274
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number16013
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: