Basic Information
Provider Information
NPI: 1407343403
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALVAREZ
FirstName: LONDY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6000 LAMAR AVE STE 130
Address2:  
City: MISSION
State: KS
PostalCode: 662023234
CountryCode: US
TelephoneNumber: 9138264200
FaxNumber:  
Practice Location
Address1: 6000 LAMAR AVE STE 130
Address2:  
City: MISSION
State: KS
PostalCode: 662023234
CountryCode: US
TelephoneNumber: 9138264200
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/16/2018
LastUpdateDate: 10/13/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/13/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700X05845KSY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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