Provider Demographics
NPI:1275915704
Name:AVOLIO, FREDERICK MICHAEL (LCPC)
Entity Type:Individual
Prefix:MR
First Name:FREDERICK
Middle Name:MICHAEL
Last Name:AVOLIO
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16228 FREDERICK RD
Mailing Address - Street 2:
Mailing Address - City:WOODBINE
Mailing Address - State:MD
Mailing Address - Zip Code:21797-8520
Mailing Address - Country:US
Mailing Address - Phone:443-414-5215
Mailing Address - Fax:
Practice Address - Street 1:1029 E BALTIMORE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-4705
Practice Address - Country:US
Practice Address - Phone:410-675-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-20
Last Update Date:2015-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC6410101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health