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General NPI Number Information
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NPI Number | 1578378642
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Entity Type | Individual
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Provider Name | JORDAN CHRISTOPHER ALVAREZ
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Gender | Male
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Dates
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Enumeration Date | 02/07/2025
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 5775 GLENRIDGE DR STE 310
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City | ATLANTA
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State | GA
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Zip | 30328-5948
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Country | US
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Telephone | 470-686-7719
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Fax |
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Provider Business Mailing Address
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Address Line | 60 11TH ST NE APT 1711
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City | ATLANTA
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State | GA
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Zip | 30309-4382
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Country | US
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Telephone | 845-674-7281
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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