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NPI Code Detail

MEDICARE: AMY AVERY LPCC

MEDICARE: AMY AVERY LPCC
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
1101YM0800XMental Health Counselor
2101YP2500XProfessional CounselorE.1400012OH

General Provider Information

NPI Number : 1629409479
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY AVERY LPCC
Provider Business Mailing Address
First Line : 9230 RAMI AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43240-2158
Country : US
Telephone Number : 614-905-1868
Fax Number : 614-416-0345
Provider Business Practice Location Address
First Line : 1900 POLARIS PKWY STE 450
Second Line :
City : COLUMBUS
State : OH
Zip : 43240-4064
Country : US
Telephone Number : 614-905-1868
Fax Number : 614-416-0345
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2013
Last Update Date : 04/07/2023

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