Healthcare Provider Details

I. General information

NPI: 1205758281
Provider Name (Legal Business Name): ANDY ALVARENGA MEJIA LCSW-A
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3012 FALSTAFF RD
RALEIGH NC
27610-1813
US

IV. Provider business mailing address

2230 BRIGHTCREEK FALLS TRL APT 307
RALEIGH NC
27610-9058
US

V. Phone/Fax

Practice location:
  • Phone: 919-615-1027
  • Fax: 919-615-1501
Mailing address:
  • Phone: 919-559-5030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP024037
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: