MEDICARE: JIM ALVES

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1841840907
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JIM ALVES

Provider Business Mailing Address
First Line	:	2110 TRESCOTT DR
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32308-0732
Country	:	US
Telephone Number	:	850-566-7607
Fax Number	:	850-386-2373

Provider Business Practice Location Address
First Line	:	211 DELTA CT
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32303-4835
Country	:	US
Telephone Number	:	850-566-7607
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. JAMES ALVES
Credential	:	LMHC
Telephone Number	:	850-566-7607

Provider Enumeration Date	:	09/19/2019
Last Update Date	:	09/19/2019

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