Provider Demographics
NPI:1023743713
Name:CHRISTENSEN, AIMEE (LPC)
Entity type:Individual
Prefix:MS
First Name:AIMEE
Middle Name:
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 533
Mailing Address - Street 2:
Mailing Address - City:KETCHUM
Mailing Address - State:ID
Mailing Address - Zip Code:83340-0481
Mailing Address - Country:US
Mailing Address - Phone:503-936-0379
Mailing Address - Fax:
Practice Address - Street 1:113 E IDAHO AVE
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-2633
Practice Address - Country:US
Practice Address - Phone:208-450-5645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLPC8902101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDLPC-8902OtherIDAHO