=====================================================
General NPI Number Information
=====================================================
NPI Number | 1073771374
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SARA INES ALVAREZ LMHC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/23/2008
-----------------------------------------------------
Last Update Date | 10/11/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1111 SE FEDERAL HWY STE 334
-----------------------------------------------------
City | STUART
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34994-3839
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 239-690-6906
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 670 NW TREEMONT AVE
-----------------------------------------------------
City | PORT ST LUCIE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34983-1065
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-484-2219
-----------------------------------------------------
Fax | 772-807-8203
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | MH8461
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------