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General NPI Number Information
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NPI Number | 1184562449
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Entity Type | Individual
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Provider Name | MR. AARON MANDZAK
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Gender | Male
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Dates
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Enumeration Date | 03/24/2026
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Last Update Date | 03/24/2026
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Provider Practice Location Address
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Address Line | 1759 LEONARD RD
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City | LEXINGTON
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State | NC
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Zip | 27295-7473
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Country | US
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Telephone | 803-467-1127
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 26221
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City | WINSTON SALEM
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State | NC
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Zip | 27114-6221
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Country | US
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Telephone | 803-467-1127
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 81638
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License Number State | TX
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