Provider Demographics
NPI:1326450701
Name:AVERY, HELEN LA VERNE (LMHC)
Entity Type:Individual
Prefix:MS
First Name:HELEN
Middle Name:LA VERNE
Last Name:AVERY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1746
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34478-1746
Mailing Address - Country:US
Mailing Address - Phone:352-301-7902
Mailing Address - Fax:352-354-9191
Practice Address - Street 1:2335 NW 10TH ST UNIT 102
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34475-5348
Practice Address - Country:US
Practice Address - Phone:352-301-7902
Practice Address - Fax:352-354-9191
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH 10727101YM0800X
FLMH13480101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLIMH 10727Medicaid