Provider Demographics
NPI:1114429164
Name:PAWLCYN, AIMEE (LPCC)
Entity type:Individual
Prefix:
First Name:AIMEE
Middle Name:
Last Name:PAWLCYN
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 FRIO RD
Mailing Address - Street 2:
Mailing Address - City:MAGDALENA
Mailing Address - State:NM
Mailing Address - Zip Code:87825-6419
Mailing Address - Country:US
Mailing Address - Phone:612-801-8499
Mailing Address - Fax:
Practice Address - Street 1:910 1ST STREET / HWY 60
Practice Address - Street 2:
Practice Address - City:MAGDALENA
Practice Address - State:NM
Practice Address - Zip Code:87825
Practice Address - Country:US
Practice Address - Phone:612-801-8499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-06
Last Update Date:2018-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0159361101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor