Provider Demographics
NPI:1659003218
Name:BENEDICT, AVERY MICHELLE (LPC-A)
Entity Type:Individual
Prefix:MS
First Name:AVERY
Middle Name:MICHELLE
Last Name:BENEDICT
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 BRADFORD BLUFF DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:TX
Mailing Address - Zip Code:77316-1691
Mailing Address - Country:US
Mailing Address - Phone:832-257-0788
Mailing Address - Fax:
Practice Address - Street 1:1001 S DAIRY ASHFORD RD STE 510
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-2375
Practice Address - Country:US
Practice Address - Phone:832-257-0788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-30
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional