Provider Demographics
NPI:1033280102
Name:CLARK, AIMEE C (LCSW)
Entity Type:Individual
Prefix:MS
First Name:AIMEE
Middle Name:C
Last Name:CLARK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:AIMEE
Other - Middle Name:
Other - Last Name:LAPORTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:8120 SHERIDAN BLVD
Mailing Address - Street 2:SUITE C114
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80033-4566
Mailing Address - Country:US
Mailing Address - Phone:303-524-4431
Mailing Address - Fax:303-474-3192
Practice Address - Street 1:8120 SHERIDAN BLVD
Practice Address - Street 2:SUITE C114
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80033-4566
Practice Address - Country:US
Practice Address - Phone:303-524-4431
Practice Address - Fax:303-474-3192
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-12
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical