MEDICARE: SAMANTHA ALVIS LPC

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	LPC.0016999	CO
2	101YP2500X	Professional Counselor		CO
3	101YP2500X	Professional Counselor	LPC.001699	CO

General Provider Information

NPI Number	:	1861950412
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA ALVIS LPC

Provider Business Mailing Address
First Line	:	4217 E EASTER PL
Second Line	:
City	:	CENTENNIAL
State	:	CO
Zip	:	80122-2250
Country	:	US
Telephone Number	:	317-450-3342
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	:	317-450-3342
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2019
Last Update Date	:	01/22/2025

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Directions to “ SAMANTHA ALVIS LPC” Practice Location

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