Brandelyn Jo Avants
Individual provider Active NPI Counselor · Davenport, IA
NPI 1346862364 · NPPES record last updated May 13, 2020
Key facts
- NPI
- 1346862364
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 906 Northbrook Dr
Davenport, IA 52806-3730 - Phone
- (563) 209-8124
- NPI assigned
- May 13, 2020
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Centered Counseling Services, LLC. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Yes |
Addresses
Primary practice location
906 Northbrook Dr
Davenport, IA 52806-3730
Mailing address
2711 W 63Rd St
Davenport, IA 52806-1647
Phone (563) 388-1039
Other providers in Davenport, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 13, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.