MEDICARE: SAMANTHA ALVIS, LLC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1396558037
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAMANTHA ALVIS, LLC.

Provider Business Mailing Address
First Line	:	4217 E EASTER PL
Second Line	:
City	:	CENTENNIAL
State	:	CO
Zip	:	80122-2250
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1990 S BROADWAY
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80210-4005
Country	:	US
Telephone Number	:	720-689-3638
Fax Number	:

Authorized Official
Title or Position	:	LICENSED PROFESSIONAL COUNSELOR
Name	:	SAMANTHA ALVIS
Credential	:
Telephone Number	:	720-689-3638

Provider Enumeration Date	:	01/28/2025
Last Update Date	:	01/28/2025

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