Healthcare Provider Details

I. General information

NPI: 1215672068
Provider Name (Legal Business Name): AIDAN HORSTMAN LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2022
Last Update Date: 05/04/2022
Certification Date: 05/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2213 NORTH LIMESTONE STREET
SPRINGFIELD OH
45503-4550
US

IV. Provider business mailing address

2213 NORTH LIMESTONE STREET
SPRINGFIELD OH
45503
US

V. Phone/Fax

Practice location:
  • Phone: 937-346-4065
  • Fax:
Mailing address:
  • Phone: 937-346-4065
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.1801233
License Number StateOH

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: