Active NPI
Angela Marie Avery, LMHC
- Mental Health Counselor
- Milton, FL
National Provider Identifier
1104091925
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MH9279
- Practice address
- 308 Merrill Dr
Milton, FL 32570-4142 - Phone
- (850) 773-6276
- NPI assigned
- Apr 23, 2008
- Last updated
- Dec 13, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MH9279 | FL | Primary |
Addresses
Primary practice location
308 Merrill Dr
Milton, FL 32570-4142
Mailing address
308 Merrill Dr
Milton, FL 32570-4142
Phone (850) 736-2767
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 5, 2026 through Feb 5, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MH9279 | FL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670889600000",
"number": "1104091925",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "308 MERRILL DR",
"city": "MILTON",
"state": "FL",
"postal_code": "325704142",
"telephone_number": "850-736-2767"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "308 MERRILL DR",
"city": "MILTON",
"state": "FL",
"postal_code": "325704142",
"telephone_number": "850-773-6276"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AVERY",
"first_name": "ANGELA",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "LMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-04-23",
"last_updated": "2022-12-13",
"certification_date": "2022-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "MH9279",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Milton, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.