Provider Demographics
NPI:1316238363
Name:ALVARANGA, SHAINE ANTHONY
Entity type:Individual
Prefix:
First Name:SHAINE
Middle Name:ANTHONY
Last Name:ALVARANGA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 VICTOR ST
Mailing Address - Street 2:APT 1
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01832
Mailing Address - Country:US
Mailing Address - Phone:978-994-4569
Mailing Address - Fax:
Practice Address - Street 1:25 VICTOR ST
Practice Address - Street 2:APT 1
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01832
Practice Address - Country:US
Practice Address - Phone:978-994-4569
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-26
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor