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General NPI Number Information
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NPI Number | 1366265357
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Entity Type | Organization
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Legal Business Name | AVERY E KERR DMIN LPC LLC
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Dates
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Enumeration Date | 11/06/2024
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Last Update Date | 03/14/2025
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Provider Practice Location Address
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Address Line | 3635 MANASSAS DR
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City | ROANOKE
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State | VA
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Zip | 24018-4031
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Country | US
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Telephone | 540-774-4686
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 772
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City | HARDY
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State | VA
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Zip | 24101-0772
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Country | US
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Telephone | 540-597-9248
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | DR. AVERY KERR
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Credential | LPC
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Telephone | 540-597-9248
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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