Provider Demographics
NPI:1396150108
Name:ALVAREZ, CARMEN TERESA (LMHC)
Entity type:Individual
Prefix:
First Name:CARMEN
Middle Name:TERESA
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1637
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34284-1637
Mailing Address - Country:US
Mailing Address - Phone:941-888-2081
Mailing Address - Fax:888-700-6760
Practice Address - Street 1:3333 CLARK RD
Practice Address - Street 2:170
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-8432
Practice Address - Country:US
Practice Address - Phone:941-888-2081
Practice Address - Fax:888-700-6760
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-01
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH4135101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health