MEDICARE: JOSE ALVAYERO

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	008471	PA

General Provider Information

NPI Number	:	1922479740
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSE ALVAYERO

Provider Business Mailing Address
First Line	:	1000 JEFFERSON ST
Second Line	:	SUITE 2C
City	:	LYNCHBURG
State	:	VA
Zip	:	24504-1723
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1800 JFK BLVD
Second Line	:	SUITE 1404
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-7421
Country	:	US
Telephone Number	:	215-399-9764
Fax Number	:

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

Provider Enumeration Date	:	10/20/2015
Last Update Date	:	10/20/2015

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