Healthcare Provider Details

I. General information

NPI: 1396930301
Provider Name (Legal Business Name): AIMEE CHIARELLA L.M.H.C., L.P.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2007
Last Update Date: 09/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 STARCREST DR
CLEARWATER FL
33765-3224
US

IV. Provider business mailing address

3741 ROSE OF SHARON DR
ORLANDO FL
32808-2734
US

V. Phone/Fax

Practice location:
  • Phone: 407-339-7451
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberIMH4835
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH9573
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number7218
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: