Healthcare Provider Details

I. General information

NPI: 1073771374
Provider Name (Legal Business Name): SARA INES ALVAREZ LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2008
Last Update Date: 10/11/2024
Certification Date: 10/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 SE FEDERAL HWY STE 334
STUART FL
34994-3839
US

IV. Provider business mailing address

670 NW TREEMONT AVE
PORT ST LUCIE FL
34983-1065
US

V. Phone/Fax

Practice location:
  • Phone: 239-690-6906
  • Fax:
Mailing address:
  • Phone: 305-484-2219
  • Fax: 772-807-8203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH8461
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: