Active NPI
Lamont Avery
- Mental Health Counselor
- San Bernardino, CA
National Provider Identifier
1194154997
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 2080 S E St
San Bernardino, CA 92408-2773 - Phone
- (909) 388-9191
- NPI assigned
- Nov 2, 2013
- Sex
- Male
- Sole proprietor
- No
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 | Primary |
Addresses
Primary practice location
2080 S E St
San Bernardino, CA 92408-2773
Mailing address
21906 Martin St
Perris, CA 92570-8702
Phone (951) 552-3895
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124100383 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Telecare Corporation | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Health Maintenance Organization
- San Bernardino, CA
- NPI 1770741282
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383350400000",
"number": "1194154997",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21906 MARTIN ST",
"city": "PERRIS",
"state": "CA",
"postal_code": "925708702",
"telephone_number": "951-552-3895"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2080 S E ST",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924082773",
"telephone_number": "909-388-9191"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AVERY",
"first_name": "LAMONT",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-11-02",
"last_updated": "2013-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1124100383",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Bernardino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.