Avery Sumpter

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

C.2405754-TRNE Issued in OH

Practice address

4891 E County Line Rd
Mineral Ridge, OH 44440-9411

Phone

(740) 564-8768

NPI assigned

Jan 8, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: avery.sumpter.p1@direct.iamboundless.nextgenshare.com

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1546905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1225501745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT 781625 PO BOX 78000",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4891 E COUNTY LINE RD",
            "city": "MINERAL RIDGE",
            "state": "OH",
            "postal_code": "444409411",
            "telephone_number": "740-564-8768"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "445 E Dublin Granville Rd",
            "address_purpose": "LOCATION",
            "city": "Worthington",
            "state": "OH",
            "postal_code": "430853192",
            "country_code": "US",
            "telephone_number": "740-564-8768",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUMPTER",
        "first_name": "AVERY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-08",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "C.2405754-TRNE",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1473276",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicholas Ryan Shearer
• E'Kayla Shields
• Angela Smith
• Lauren Nicole Stewart
• Michael D Strange, LMT
• Pamela Denise Sweeney, MHHS, LSW
• Tamara Lynn Tabor-Glancy, M.ED., CRC, LPC
• Matisha Renee Tensley
• Michael Anthony Turkali, CHIROPRACTOR
• Weathersfield Local School District

• Professional Counselor in Mineral Ridge, OH
• Providers in Mineral Ridge, OH by specialty
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.