Avalon Psychological Center, PLLC
Psychologist, Counseling in Somerset, KY. Organization (NPI-2).
NPI number1295018331
StatusActive
Last updated in NPPESApr 8, 2015
Details
- NPI
- 1295018331
- Entity type
- Organization (NPI-2)
- Legal business name
- Avalon Psychological Center, PLLC
- Organization subpart
- No
- Enumeration date
- Sep 26, 2011
- Last updated
- Apr 8, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC1900X | Psychologist, Counseling | 0068 | KY | Yes |
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | 0864 | KY | |
| 1041C0700X | Social Worker, Clinical | 2057 | KY | |
| 1041C0700X | Social Worker, Clinical | 350 | KY |
Practice location
106 Southport Dr.Somerset, KY 42501
Phone 606-677-0053 · Fax 606-677-0060
Mailing address
106 Southport Dr.Somerset, KY 42501
Phone 606-677-0053 · Fax 606-677-0060
Authorized official
Vaunette L. Baker
Owner
6066770053
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