Provider Demographics
NPI:1194575639
Name:ALVAREZ, JAY METZTLI (LSW)
Entity type:Individual
Prefix:
First Name:JAY
Middle Name:METZTLI
Last Name:ALVAREZ
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11000 ROUTE 34
Mailing Address - Street 2:SUITE 3
Mailing Address - City:PLANO
Mailing Address - State:IL
Mailing Address - Zip Code:60545
Mailing Address - Country:US
Mailing Address - Phone:847-457-6730
Mailing Address - Fax:
Practice Address - Street 1:11000 ROUTE 34
Practice Address - Street 2:SUITE 3
Practice Address - City:PLANO
Practice Address - State:IL
Practice Address - Zip Code:60545
Practice Address - Country:US
Practice Address - Phone:847-457-6730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.109041104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker