Nichelle Alva, LMFT

Individual provider Active NPI Marriage & Family Therapist · Auburn, NY

NPI 1316616469 · NPPES record last updated Sep 12, 2021

Key facts

NPI
1316616469
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
119610 (CA)
Practice address
8 Tuxill SQ
Auburn, NY 13021-3915
Phone
(612) 229-0970
NPI assigned
Sep 12, 2021
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
119610CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Brightside Medical, P.C. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 119610 CA Yes

Addresses

Primary practice location

8 Tuxill SQ
Auburn, NY 13021-3915

Mailing address

8 Tuxill SQ
Auburn, NY 13021-3915
Phone (612) 229-0970

Other providers in Auburn, NY

All providers in Auburn, NY · Marriage & Family Therapist in New York

Sources for this page

Verify at the official NPI Registry.