Provider Demographics
NPI:1427636943
Name:WILSON, AARON N (LMFT)
Entity type:Individual
Prefix:MR
First Name:AARON
Middle Name:N
Last Name:WILSON
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 BROOKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95065-1517
Mailing Address - Country:US
Mailing Address - Phone:864-551-8143
Mailing Address - Fax:
Practice Address - Street 1:100 BROOKWOOD DR
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95065-1517
Practice Address - Country:US
Practice Address - Phone:415-779-5224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-29
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA125204101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health