Provider Demographics
NPI:1275560310
Name:AVEYARD, ROGER LOUIS (LMHP)
Entity Type:Individual
Prefix:DR
First Name:ROGER
Middle Name:LOUIS
Last Name:AVEYARD
Suffix:
Gender:M
Credentials:LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 COURT ST.
Mailing Address - Street 2:
Mailing Address - City:BEATRICE
Mailing Address - State:NM
Mailing Address - Zip Code:68310-3927
Mailing Address - Country:US
Mailing Address - Phone:402-228-4968
Mailing Address - Fax:402-228-3677
Practice Address - Street 1:707 COURT ST.
Practice Address - Street 2:
Practice Address - City:BEATRICE
Practice Address - State:NE
Practice Address - Zip Code:68310-3927
Practice Address - Country:US
Practice Address - Phone:402-228-4968
Practice Address - Fax:402-228-3677
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE518101YM0800X
NE4101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional