=====================================================
General NPI Number Information
=====================================================
NPI Number | 1093411993
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALIVIO COUNSELING CENTER, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/01/2023
-----------------------------------------------------
Last Update Date | 06/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 223 W GATEHOUSE DR APT D
-----------------------------------------------------
City | METAIRIE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70001-2031
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 318-464-5290
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2924 KNIGHT ST STE 402
-----------------------------------------------------
City | SHREVEPORT
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 71105-2413
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 318-464-5290
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | VICTORIA VASQUEZ ANDRADE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 318-464-5290
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM0801X
-----------------------------------------------------
Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------