Healthcare Provider Details

I. General information

NPI: 1952040958
Provider Name (Legal Business Name): VERONICA AVEDICIAN LCPC, LPC, NCC, TCTH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2022
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 S NORTHWEST HWY
BARRINGTON IL
60010-4608
US

IV. Provider business mailing address

116 S NORTHWEST HWY
BARRINGTON IL
60010-4608
US

V. Phone/Fax

Practice location:
  • Phone: 503-476-1148
  • Fax: 503-388-3671
Mailing address:
  • Phone: 503-476-1148
  • Fax: 503-388-3671

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180.017464
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: