NPIMap

Organization Active NPI

Avalon Psychological Center, PLLC

  • Counseling Psychologist
  • Somerset, KY
National Provider Identifier
1295018331
Registry record updated Apr 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
0068 Issued in KY
Legal business name
AVALON PSYCHOLOGICAL CENTER, PLLC
Practice address
106 Southport Dr.
Somerset, KY 42501
Phone
(606) 677-0053
Fax
(606) 677-0060
NPI assigned
Sep 26, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2015

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

Authorized official

Name
Vaunette L. Baker, LPPNPI 1831126903
Title
Owner
Phone
(606) 677-0053

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X 0864 KY
Counseling PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC1900X 0068 KY Primary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 2057 KY
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 350 KY

Addresses

Primary practice location

106 Southport Dr.
Somerset, KY 42501

Mailing address

106 Southport Dr.
Somerset, KY 42501
Phone (606) 677-0053

National Provider Directory

National Provider Directory

Locations

106 Southport Dr
Somerset, KY 42501
Phone (606) 677-0053

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1316995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428451200000",
    "number": "1295018331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 SOUTHPORT DR.",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "42501",
            "telephone_number": "606-677-0053",
            "fax_number": "606-677-0060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 SOUTHPORT DR.",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "42501",
            "telephone_number": "606-677-0053",
            "fax_number": "606-677-0060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVALON PSYCHOLOGICAL CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-26",
        "last_updated": "2015-04-08",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "VAUNETTE",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "606-677-0053",
        "authorized_official_credential": "LPP"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KY",
            "license": "0864",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": "KY",
            "license": "0068",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "2057",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "350",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2015; 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.