Averyl Reid, MA, QMHP

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

9150 E 109TH Ave Ste 1B
Crown Point, IN 46307-7686

Phone

(219) 743-2488

NPI assigned

Oct 29, 2017

Last updated

Oct 29, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Averyl Hudson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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

{
    "created_epoch": "1509235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509235200000",
    "number": "1790297885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9150 E 109TH AVE STE 1B",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463077686",
            "telephone_number": "219-743-2488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9150 E 109TH AVE STE 1B",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463077686",
            "telephone_number": "219-743-2488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REID",
        "first_name": "AVERYL",
        "credential": "MA, QMHP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-29",
        "last_updated": "2017-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AVERYL",
            "last_name": "HUDSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Mental Health Counselor in Crown Point, IN
• Providers in Crown Point, IN by specialty
• Mental Health Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2017; 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.