Provider Demographics
NPI:1508851528
Name:LANDRY, AARON MICHAEL (LCSW)
Entity Type:Individual
Prefix:MR
First Name:AARON
Middle Name:MICHAEL
Last Name:LANDRY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 HIDDEN OAKS DR
Mailing Address - Street 2:
Mailing Address - City:GREENE
Mailing Address - State:ME
Mailing Address - Zip Code:04236-3368
Mailing Address - Country:US
Mailing Address - Phone:863-251-2116
Mailing Address - Fax:
Practice Address - Street 1:10 WARE ST
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-6214
Practice Address - Country:US
Practice Address - Phone:207-298-1676
Practice Address - Fax:207-298-1676
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL167601041C0700X
MELC110341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical