Provider Demographics
NPI:1639936552
Name:BOILEAU, AARON J (MS, LMHC-A)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:J
Last Name:BOILEAU
Suffix:
Gender:M
Credentials:MS, LMHC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9335 CALUMET AVE STE D
Mailing Address - Street 2:
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-4176
Mailing Address - Country:US
Mailing Address - Phone:219-595-9494
Mailing Address - Fax:
Practice Address - Street 1:9335 CALUMET AVE STE D
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-4176
Practice Address - Country:US
Practice Address - Phone:219-595-9494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN99121214A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health