Provider Demographics
NPI:1972019610
Name:STANFORD, AARON (LMSW)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:STANFORD
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 WRIGHT AVE
Mailing Address - Street 2:
Mailing Address - City:ALMA
Mailing Address - State:MI
Mailing Address - Zip Code:48801-1617
Mailing Address - Country:US
Mailing Address - Phone:989-463-4971
Mailing Address - Fax:989-466-5470
Practice Address - Street 1:608 WRIGHT AVE
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:MI
Practice Address - Zip Code:48801-1617
Practice Address - Country:US
Practice Address - Phone:989-463-4971
Practice Address - Fax:989-466-5470
Is Sole Proprietor?:No
Enumeration Date:2017-12-18
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68020894851041C0700X
MI68011154281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical