Provider Demographics
NPI:1851040588
Name:IMBER, AARON SETH (LCSW)
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:SETH
Last Name:IMBER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1532 W 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-4910
Mailing Address - Country:US
Mailing Address - Phone:302-388-2929
Mailing Address - Fax:
Practice Address - Street 1:1532 W 3RD AVE
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-4910
Practice Address - Country:US
Practice Address - Phone:302-388-2929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-21
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.099279711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical