Provider Demographics
NPI:1114365665
Name:WHALEY, AIMEE MARIE (LPC)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:MARIE
Last Name:WHALEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:AIMEE
Other - Middle Name:
Other - Last Name:WHALEY THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:317 MATTHEWS MINT HILL RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-2893
Mailing Address - Country:US
Mailing Address - Phone:704-879-5483
Mailing Address - Fax:844-644-5238
Practice Address - Street 1:317 MATTHEWS MINT HILL RD
Practice Address - Street 2:SUITE 104
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-2893
Practice Address - Country:US
Practice Address - Phone:704-879-5483
Practice Address - Fax:844-644-5238
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-06
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10252101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC32639Medicaid