Provider Demographics
NPI:1104620400
Name:GREEN, AARON (LCSW)
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:GREEN
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1080 S MILITARY TRL APT 303
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-7647
Mailing Address - Country:US
Mailing Address - Phone:210-232-6649
Mailing Address - Fax:
Practice Address - Street 1:1080 S MILITARY TRL
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-7691
Practice Address - Country:US
Practice Address - Phone:210-232-6649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW242371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty