Healthcare Provider Details

I. General information

NPI: 1134047798
Provider Name (Legal Business Name): DIANA ALVAREZ LPCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 EAST AVE
NORWALK CT
06851-5010
US

IV. Provider business mailing address

11 TIERNEY ST
NORWALK CT
06851-5912
US

V. Phone/Fax

Practice location:
  • Phone: 203-299-1315
  • Fax:
Mailing address:
  • Phone: 203-299-1315
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number4849
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: