Provider Demographics
NPI:1104192616
Name:AARSHEIM, MARY JANE (LCSW)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:JANE
Last Name:AARSHEIM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11440 PLEASANT VALLEY RD STE C
Mailing Address - Street 2:
Mailing Address - City:PENN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95946-9175
Mailing Address - Country:US
Mailing Address - Phone:916-580-9820
Mailing Address - Fax:
Practice Address - Street 1:11440 PLEASANT VALLEY RD STE C
Practice Address - Street 2:
Practice Address - City:PENN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95946-9175
Practice Address - Country:US
Practice Address - Phone:916-580-9820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-29
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA281211041C0700X
TN35811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical