Provider Demographics
NPI:1720790033
Name:GLEAVES, AARON
Entity Type:Individual
Prefix:MR
First Name:AARON
Middle Name:
Last Name:GLEAVES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 S HILL DR STE A
Mailing Address - Street 2:
Mailing Address - City:BLACKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24060-5709
Mailing Address - Country:US
Mailing Address - Phone:276-233-2694
Mailing Address - Fax:
Practice Address - Street 1:103 S HILL DR STE A
Practice Address - Street 2:
Practice Address - City:BLACKSBURG
Practice Address - State:VA
Practice Address - Zip Code:24060-5709
Practice Address - Country:US
Practice Address - Phone:276-233-2694
Practice Address - Fax:540-779-7724
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0704014310101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health