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General NPI Number Information
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NPI Number | 1578275079
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Entity Type | Individual
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Provider Name | DESIREE RENE ALVARADO LPC
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Gender | Female
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Dates
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Enumeration Date | 12/16/2022
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Last Update Date | 12/18/2022
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Provider Practice Location Address
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Address Line | 12702 TOEPPERWEIN RD STE 215
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City | LIVE OAK
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State | TX
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Zip | 78233-3250
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Country | US
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Telephone | 512-537-4065
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Fax | 512-539-2881
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Provider Business Mailing Address
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Address Line | 2607 PARIA CYN
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City | CONVERSE
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State | TX
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Zip | 78109-3767
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Country | US
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Telephone | 210-316-6694
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 84497
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License Number State | TX
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