Active NPI
Michelle Community Counseling Avedissian
- Drama Therapist
- Tracy, CA
National Provider Identifier
1194674366
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Drama Therapist
- License
- AMFT158008
- Practice address
- 19 E 6TH St # 95376
Tracy, CA 95376-4107 - Phone
- (209) 835-8583
- Fax
- (209) 835-8583
- NPI assigned
- Jan 22, 2026
- 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 |
|---|---|---|---|---|
| Drama Therapist | 101200000X | AMFT158008 | CA | Primary |
Addresses
Primary practice location
19 E 6TH St # 95376
Tracy, CA 95376-4107
Mailing address
19 E 6TH St # 95376
Tracy, CA 95376-4107
Phone (209) 835-8583
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AMFT158008 | CA | MD | Drama Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Valley Community Counseling Services, Inc | 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.
-
- Community/Behavioral Health Agency
- Tracy, CA
- NPI 1629191978
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1769040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1769040000000",
"number": "1194674366",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19 E 6TH ST # 95376",
"city": "TRACY",
"state": "CA",
"postal_code": "953764107",
"telephone_number": "209-835-8583",
"fax_number": "209-835-8583"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19 E 6TH ST # 95376",
"city": "TRACY",
"state": "CA",
"postal_code": "953764107",
"telephone_number": "209-835-8583",
"fax_number": "209-835-8583"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AVEDISSIAN",
"first_name": "MICHELLE",
"middle_name": "COMMUNITY COUNSELING",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2026-01-22",
"last_updated": "2026-01-22",
"certification_date": "2026-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "101200000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Drama Therapist",
"state": "CA",
"license": "AMFT158008",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tracy, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.