Healthcare Provider Details

I. General information

NPI: 1326450701
Provider Name (Legal Business Name): HELEN LA VERNE AVERY LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2014
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2335 NW 10TH ST UNIT 102
OCALA FL
34475-5348
US

IV. Provider business mailing address

PO BOX 1746
OCALA FL
34478-1746
US

V. Phone/Fax

Practice location:
  • Phone: 352-301-7902
  • Fax: 352-354-9191
Mailing address:
  • Phone: 352-301-7902
  • Fax: 352-354-9191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberIMH 10727
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH13480
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: