Provider Demographics
NPI:1104307453
Name:CHALIFOUX, AIMEE (LICSW)
Entity type:Individual
Prefix:
First Name:AIMEE
Middle Name:
Last Name:CHALIFOUX
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:577 UNION ST
Mailing Address - Street 2:
Mailing Address - City:DUXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02332-3020
Mailing Address - Country:US
Mailing Address - Phone:860-681-8513
Mailing Address - Fax:
Practice Address - Street 1:577 UNION ST
Practice Address - Street 2:
Practice Address - City:DUXBURY
Practice Address - State:MA
Practice Address - Zip Code:02332-3020
Practice Address - Country:US
Practice Address - Phone:860-681-8513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-24
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10321101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical