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NPI Code Detail

MEDICARE: DR. CHRISTIAN ALAN AVERY PHD

MEDICARE: DR. CHRISTIAN ALAN AVERY PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist546457WI
2163W00000XRegistered Nurse16750930WI
3103TP2701XGroup Psychotherapy Psychologist

General Provider Information

NPI Number : 1033073739
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHRISTIAN ALAN AVERY PHD
Provider Business Mailing Address
First Line : 1032 S CESAR E CHAVEZ DR
Second Line :
City : MILWAUKEE
State : WI
Zip : 53204-2203
Country : US
Telephone Number : 414-672-1353
Fax Number :
Provider Business Practice Location Address
First Line : 2906 S 20TH ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53215-3732
Country : US
Telephone Number : 414-672-1353
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/16/2025
Last Update Date : 05/11/2026

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