Provider Demographics
NPI:1952040958
Name:AVEDICIAN, VERONICA (MS, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:AVEDICIAN
Suffix:
Gender:F
Credentials:MS, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1715 NICHOLS LN
Mailing Address - Street 2:
Mailing Address - City:FOREST GROVE
Mailing Address - State:OR
Mailing Address - Zip Code:97116-3216
Mailing Address - Country:US
Mailing Address - Phone:503-359-4057
Mailing Address - Fax:503-359-4756
Practice Address - Street 1:1715 NICHOLS LN
Practice Address - Street 2:
Practice Address - City:FOREST GROVE
Practice Address - State:OR
Practice Address - Zip Code:97116-3216
Practice Address - Country:US
Practice Address - Phone:503-359-4057
Practice Address - Fax:503-359-4756
Is Sole Proprietor?:No
Enumeration Date:2022-05-31
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health