Healthcare Provider Details

I. General information

NPI: 1124251889
Provider Name (Legal Business Name): AARON I ANDERSON M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2009
Last Update Date: 01/23/2023
Certification Date: 01/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1511 W 124TH AVE STE 200
WESTMINSTER CO
80234
US

IV. Provider business mailing address

1511 W 124TH AVE. STE 200
WESTMINSTER CO
80234
US

V. Phone/Fax

Practice location:
  • Phone: 720-648-8285
  • Fax: 720-808-1594
Mailing address:
  • Phone: 720-648-8285
  • Fax: 720-808-1594

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number13699
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number8966
License Number StateNE
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number1061
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: