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Vivacity/ Ashleigh Ward billing and business management matters Name Tiffanie A. Williams LCSW Director Barry Alvarez LMFT Clinical Supervisor Address 420 Justin Dr Phone Palmyra VA 44263 Address 121 S. Alfred St Phone 571-245-6109 Alexandria VA 22314 Address 207 Park Ave Falls Phone 703-509-2217 Church Va Client s Initials Address Signatures Client s Signature Date Parent/Guardian Signature Witness Authorization for the Release of Confidential Information Page 2 TURNING POINT COUNSELING...
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