Healthcare Provider Details

I. General information

NPI: 1164348702
Provider Name (Legal Business Name): ALVARO ALARCON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2026
Last Update Date: 06/27/2026
Certification Date: 06/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6563 EDSALL RD
SPRINGFIELD VA
22151-4414
US

IV. Provider business mailing address

4005 ROBERTS RD
FAIRFAX VA
22032-1041
US

V. Phone/Fax

Practice location:
  • Phone: 703-354-0000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0732006372
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: