Provider Demographics
NPI:1942213574
Name:AARON-BRASS, LORENE (LICSW, LMFT)
Entity Type:Individual
Prefix:
First Name:LORENE
Middle Name:
Last Name:AARON-BRASS
Suffix:
Gender:F
Credentials:LICSW, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:902 2ND AVE S
Mailing Address - Street 2:
Mailing Address - City:SAINT JAMES
Mailing Address - State:MN
Mailing Address - Zip Code:56081-2108
Mailing Address - Country:US
Mailing Address - Phone:507-375-5688
Mailing Address - Fax:507-375-5688
Practice Address - Street 1:116 7TH ST S
Practice Address - Street 2:
Practice Address - City:SAINT JAMES
Practice Address - State:MN
Practice Address - Zip Code:56081-1756
Practice Address - Country:US
Practice Address - Phone:507-375-5688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN54051041C0700X
MN475106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN3G885BROtherCONTRACT PROVIDER NUMBER
MN3G886BROtherINDIVIDUAL PROVIDER NUMBE
MN6263986OtherUNITED BEHAVIORAL HEALTH
MN116473OtherUCARE/BHP