Healthcare Provider Details

I. General information

NPI: 1205466299
Provider Name (Legal Business Name): LORENA ALVAREZ LPCC, LPAT, ATR-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2020
Last Update Date: 06/21/2024
Certification Date: 06/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1605 YOUNG ST
SANTA FE NM
87505-3505
US

IV. Provider business mailing address

1605 YOUNG ST
SANTA FE NM
87505-3505
US

V. Phone/Fax

Practice location:
  • Phone: 561-376-1900
  • Fax:
Mailing address:
  • Phone: 561-376-1900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License NumberCAT0188151
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCCMH0191231
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: