Vicky Avery

Primary specialty

Prevention ProfessionalTaxonomy code 405300000X

License

823032 Issued in MI

Practice address

13560 E McNichols Rd
Detroit, MI 48205-3426

Phone

(313) 883-3300

Fax

(313) 731-0156

NPI assigned

May 23, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Minds Moving in New Directions Inc

  • Community/Behavioral Health Agency
  • Highland Park, MI
  • NPI 1134502354
  NPD Authorized official

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

{
    "created_epoch": "1495497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1942737853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 MASSACHUSETTS ST",
            "city": "HIGHLAND PARK",
            "state": "MI",
            "postal_code": "482033537",
            "telephone_number": "313-282-5832",
            "fax_number": "313-731-0156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13560 E MCNICHOLS RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482053426",
            "telephone_number": "313-883-3300",
            "fax_number": "313-731-0156"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "62 Massachusetts St",
            "address_purpose": "LOCATION",
            "city": "Highland Park",
            "state": "MI",
            "postal_code": "482033537",
            "country_code": "US",
            "telephone_number": "313-282-5832",
            "fax_number": "313-731-0156",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AVERY",
        "first_name": "VICKY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-23",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "405300000X",
            "taxonomy_group": "",
            "desc": "Prevention Professional",
            "state": "MI",
            "license": "823032",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1134502354",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pallavi Avasarala
• Rodney Harold Averett
• Averies Care Services LLC
• Andrew Avery, MD
• Hattie Denise Avery
• Konstantinos Avgerinos, MD
• Dulce Iveth Vargas Aviles, APRN, CPNP-PC
• Tiji Avirah, PT
• Avortex Counseling and Coaching Services
• Avortex Wellness Group LLC

• Prevention Professional in Detroit, MI
• Providers in Detroit, MI by specialty
• Prevention Professional in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.