Healthcare Provider Details

I. General information

NPI: 1235696170
Provider Name (Legal Business Name): SHAUNTA ADAMS ALVAREZ MS, LCMHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2019
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3709 W MARKET ST
GREENSBORO NC
27403-4432
US

IV. Provider business mailing address

PO BOX 3367
BURLINGTON NC
27215-0367
US

V. Phone/Fax

Practice location:
  • Phone: 336-464-5743
  • Fax:
Mailing address:
  • Phone: 336-534-6510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA21208
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: