Provider Demographics
NPI:1124251889
Name:ANDERSON, AARON I (MS)
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:I
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1511 W 124TH AVE.
Mailing Address - Street 2:STE 200
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80234
Mailing Address - Country:US
Mailing Address - Phone:720-648-8285
Mailing Address - Fax:720-808-1594
Practice Address - Street 1:1511 W 124TH AVE
Practice Address - Street 2:STE 200
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80234
Practice Address - Country:US
Practice Address - Phone:720-648-8285
Practice Address - Fax:720-808-1594
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-28
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO13699101YM0800X
NE8966101YM0800X
CO1061106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE8966OtherNE LICENSE
CO13699OtherCO MENTAL HEALTH BOARD