Provider Demographics
NPI:1508678681
Name:CLEMENT, AVERY (LPC-ASSOCIATE)
Entity type:Individual
Prefix:
First Name:AVERY
Middle Name:
Last Name:CLEMENT
Suffix:
Gender:F
Credentials:LPC-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2309 AURORA DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-7642
Mailing Address - Country:US
Mailing Address - Phone:903-517-4735
Mailing Address - Fax:
Practice Address - Street 1:2115 TEAKWOOD LN STE 100
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-4407
Practice Address - Country:US
Practice Address - Phone:214-444-3649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-24
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX89080101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty