Provider Demographics
NPI:1023662863
Name:SPIVAK, AARON JOSEPH (LMHC)
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:JOSEPH
Last Name:SPIVAK
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84 FORSHAY RD
Mailing Address - Street 2:
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952-1403
Mailing Address - Country:US
Mailing Address - Phone:845-642-1199
Mailing Address - Fax:
Practice Address - Street 1:84 FORSHAY RD
Practice Address - Street 2:
Practice Address - City:MONSEY
Practice Address - State:NY
Practice Address - Zip Code:10952-1403
Practice Address - Country:US
Practice Address - Phone:845-642-1199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-30
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009691101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health