Healthcare Provider Details

I. General information

NPI: 1255251013
Provider Name (Legal Business Name): AVERY BLAKE DAY M.ED, ED.S., LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 S PINE ST STE A
SPARTANBURG SC
29302-3311
US

IV. Provider business mailing address

730 DAVIS COOK DR APT G03
WELLFORD SC
29385-8312
US

V. Phone/Fax

Practice location:
  • Phone: 864-515-6440
  • Fax:
Mailing address:
  • Phone: 813-777-9911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number12506
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: