Provider Demographics
NPI:1720616048
Name:STOCKENSTROOM, AIMEE (LCSW)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:
Last Name:STOCKENSTROOM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:AIMEE
Other - Middle Name:
Other - Last Name:BOWER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:105A LEW DEWITT BLVD # 250
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:VA
Mailing Address - Zip Code:22980-1658
Mailing Address - Country:US
Mailing Address - Phone:540-490-1419
Mailing Address - Fax:
Practice Address - Street 1:2008 BREMO RD STE 103
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-2443
Practice Address - Country:US
Practice Address - Phone:540-305-3808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-31
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040070411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical