Provider Demographics
NPI:1962619130
Name:ALLEN, AARON PAUL (MA, LPC)
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:PAUL
Last Name:ALLEN
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 2 BOX 279AE
Mailing Address - Street 2:
Mailing Address - City:DONIPHAN
Mailing Address - State:MO
Mailing Address - Zip Code:63935-8032
Mailing Address - Country:US
Mailing Address - Phone:573-996-9432
Mailing Address - Fax:
Practice Address - Street 1:204 E MAIN ST
Practice Address - Street 2:BOX 412
Practice Address - City:WEST PLAINS
Practice Address - State:MO
Practice Address - Zip Code:65775-3525
Practice Address - Country:US
Practice Address - Phone:417-255-2273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002032319101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional