Provider Demographics
NPI:1295115665
Name:ALVAREZ, DIEGO (LCSW)
Entity type:Individual
Prefix:
First Name:DIEGO
Middle Name:
Last Name:ALVAREZ
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 CHATHAM LN
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06010-5275
Mailing Address - Country:US
Mailing Address - Phone:860-302-8503
Mailing Address - Fax:
Practice Address - Street 1:255 BANK ST FL 4
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06702-2219
Practice Address - Country:US
Practice Address - Phone:203-596-9724
Practice Address - Fax:203-759-0566
Is Sole Proprietor?:No
Enumeration Date:2015-06-01
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X, 1041C0700X
CT135001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator