Provider Demographics
NPI:1649865130
Name:CALLICUTT, AIMEE NICOLE (MS, LCMHCA, LCASA)
Entity type:Individual
Prefix:
First Name:AIMEE
Middle Name:NICOLE
Last Name:CALLICUTT
Suffix:
Gender:F
Credentials:MS, LCMHCA, LCASA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3706 MULBERRY LN
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-1858
Mailing Address - Country:US
Mailing Address - Phone:336-870-4768
Mailing Address - Fax:
Practice Address - Street 1:116 ROCKSPRING RD
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-0801
Practice Address - Country:US
Practice Address - Phone:336-000-0000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-05
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)