Provider Demographics
NPI:1194976944
Name:ALVARADO, OSVALDO A (MCC, REV)
Entity type:Individual
Prefix:MR
First Name:OSVALDO
Middle Name:A
Last Name:ALVARADO
Suffix:
Gender:M
Credentials:MCC, REV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6925 LONEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80925-9590
Mailing Address - Country:US
Mailing Address - Phone:719-331-7553
Mailing Address - Fax:
Practice Address - Street 1:6925 LONEWOOD DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80925-9590
Practice Address - Country:US
Practice Address - Phone:719-331-7553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-09
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor