Provider Demographics
NPI:1063293884
Name:COONEY, AIMEE
Entity type:Individual
Prefix:
First Name:AIMEE
Middle Name:
Last Name:COONEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:188 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:CT
Mailing Address - Zip Code:06377-1823
Mailing Address - Country:US
Mailing Address - Phone:860-230-5861
Mailing Address - Fax:
Practice Address - Street 1:188 MAIN ST
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:CT
Practice Address - Zip Code:06377-1823
Practice Address - Country:US
Practice Address - Phone:860-230-5861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT3269106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist