| Alivio Counseling Center, Llc | |
|
2924 Knight St Ste 402 Shreveport LA 71105-2413 | |
| (318) 464-5290 | |
| Not Available |
| Full Name | Alivio Counseling Center, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2924 Knight St Ste 402, Shreveport, Louisiana |
| Authorized Official Name and Position | Victoria Vasquez Andrade (OWNER) |
| Authorized Official Contact | 3184645290 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alivio Counseling Center, Llc 2924 Knight St Ste 402 Shreveport LA 71105-2413 Ph: (318) 464-5290 | Alivio Counseling Center, Llc 2924 Knight St Ste 402 Shreveport LA 71105-2413 Ph: (318) 464-5290 |
| NPI Number | 1093411993 |
|---|---|
| Provider Enumeration Date | 02/01/2023 |
| Last Update Date | 02/01/2023 |
| Certification Date | 02/01/2023 |
| Medicare PECOS PAC ID | 6608249651 |
|---|---|
| Medicare Enrollment ID | O20230222002559 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093411993 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Victoria Vasquez Andrade |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801564661 PECOS PAC ID: 3274922372 Enrollment ID: I20211111000158 |
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