| Avery E Kerr Dmin Lpc Llc | |
|
3635 Manassas Dr Roanoke VA 24018-4031 | |
| (540) 774-4686 | |
| Not Available |
| Full Name | Avery E Kerr Dmin Lpc Llc |
|---|---|
| Speciality | Counselor |
| Location | 3635 Manassas Dr, Roanoke, Virginia |
| Authorized Official Name and Position | Avery Kerr (COUNSELOR) |
| Authorized Official Contact | 5405979248 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Avery E Kerr Dmin Lpc Llc Po Box 772 Hardy VA 24101-0772 Ph: (540) 597-9248 | Avery E Kerr Dmin Lpc Llc 3635 Manassas Dr Roanoke VA 24018-4031 Ph: (540) 774-4686 |
| NPI Number | 1366265357 |
|---|---|
| Provider Enumeration Date | 11/06/2024 |
| Last Update Date | 03/14/2025 |
| Certification Date | 03/14/2025 |
| Medicare PECOS PAC ID | 4789106410 |
|---|---|
| Medicare Enrollment ID | O20250321002217 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366265357 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Avery E Kerr |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1023288024 PECOS PAC ID: 2466803002 Enrollment ID: I20240109001224 |
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