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General NPI Number Information
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NPI Number | 1639303191
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Entity Type | Individual
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Provider Name | BRENDA Y. AVERETT L.P.C.,L.S.W.
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Gender | Female
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Dates
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Enumeration Date | 05/12/2009
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Last Update Date | 05/12/2009
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Provider Practice Location Address
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Address Line | 302 NORTH HURON
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City | YPSILANTI
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State | MI
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Zip | 48197
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Country | US
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Telephone | 734-834-7447
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Fax | 734-483-6326
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Provider Business Mailing Address
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Address Line | 302 N HURON ST
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City | YPSILANTI
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State | MI
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Zip | 48197-2947
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Country | US
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Telephone | 734-834-7447
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Fax | 734-483-6326
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6401003040
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number | SC0000229
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 6802059684
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License Number State | MI
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