Active NPI
Angeliqueca Avery, LPC
- Professional Counselor
- Port Arthur, TX
National Provider Identifier
1972833028
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 60868
- Practice address
- 8700 9TH Ave Ste 106
Port Arthur, TX 77642-8069 - Phone
- (409) 729-8805
- NPI assigned
- Jan 12, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 60868 | TX | Primary |
Addresses
Primary practice location
8700 9TH Ave Ste 106
Port Arthur, TX 77642-8069
Mailing address
1009 Westmeadow Dr
Beaumont, TX 77706-3876
Phone (409) 656-7755
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60868 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1263254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1263254400000",
"number": "1972833028",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1009 WESTMEADOW DR",
"city": "BEAUMONT",
"state": "TX",
"postal_code": "777063876",
"telephone_number": "409-656-7755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8700 9TH AVE STE 106",
"city": "PORT ARTHUR",
"state": "TX",
"postal_code": "776428069",
"telephone_number": "409-729-8805"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AVERY",
"first_name": "ANGELIQUECA",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-01-12",
"last_updated": "2010-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "60868",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Arthur, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.