Provider Demographics
NPI:1457990095
Name:WOODS, AARON (LMSW)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:WOODS
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 1:63 STEVEN PL
Mailing Address - Street 2:
Mailing Address - City:CORAM
Mailing Address - State:NY
Mailing Address - Zip Code:11727-4500
Mailing Address - Country:US
Mailing Address - Phone:631-335-3282
Mailing Address - Fax:
Practice Address - Street 1:63 STEVEN PL
Practice Address - Street 2:
Practice Address - City:CORAM
Practice Address - State:NY
Practice Address - Zip Code:11727-4500
Practice Address - Country:US
Practice Address - Phone:631-335-3282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-30
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043954-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker