MEDICARE: ADRIENNE E AVERY MA, LPC, RPT

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
1	101YM0800X	Mental Health Counselor	LPC.0019001	CO

General Provider Information

NPI Number	:	1265190532
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADRIENNE E AVERY MA, LPC, RPT

Provider Business Mailing Address
First Line	:	9533 JOYCE LN
Second Line	:
City	:	HIGHLANDS RANCH
State	:	CO
Zip	:	80126-3033
Country	:	US
Telephone Number	:	303-827-4736
Fax Number	:

Provider Business Practice Location Address
First Line	:	6087 S QUEBEC ST STE 102
Second Line	:
City	:	CENTENNIAL
State	:	CO
Zip	:	80111-4539
Country	:	US
Telephone Number	:	720-772-1421
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/03/2021
Last Update Date	:	11/15/2023

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