1427175280 NPI number — MS. CANDICE ANNE ALVAREZ M.S.W., L.C.S.W.

Table of content: MS. CANDICE ANNE ALVAREZ M.S.W., L.C.S.W. (NPI 1427175280)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427175280 NPI number — MS. CANDICE ANNE ALVAREZ M.S.W., L.C.S.W.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALVAREZ
Provider First Name:
CANDICE
Provider Middle Name:
ANNE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
M.S.W., L.C.S.W.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ALVAREZ
Provider Other First Name:
CANDICE
Provider Other Middle Name:
KOLES
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.S.W., L.C.S.W.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1427175280
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
65 MOUNTAIN BLVD EXT
Provider Second Line Business Mailing Address:
SUITE 210
Provider Business Mailing Address City Name:
WARREN
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07059-2632
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
908-231-9020
Provider Business Mailing Address Fax Number:
732-356-0507

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
65 MOUNTAIN BLVD EXT
Provider Second Line Business Practice Location Address:
SUITE 210
Provider Business Practice Location Address City Name:
WARREN
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07059-2632
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
908-231-9020
Provider Business Practice Location Address Fax Number:
732-356-0507
Provider Enumeration Date:
03/24/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  44SC00367000 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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