Provider Demographics
NPI:1831714963
Name:ANCIAUX, AARON (LCSW, LAC)
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:ANCIAUX
Suffix:
Gender:M
Credentials:LCSW, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25155 THOMPSON DR
Mailing Address - Street 2:
Mailing Address - City:HUSON
Mailing Address - State:MT
Mailing Address - Zip Code:59846-8518
Mailing Address - Country:US
Mailing Address - Phone:208-401-4380
Mailing Address - Fax:
Practice Address - Street 1:25155 THOMPSON DR
Practice Address - Street 2:
Practice Address - City:HUSON
Practice Address - State:MT
Practice Address - Zip Code:59846-8518
Practice Address - Country:US
Practice Address - Phone:208-401-4380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-15
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LAC-LIC-43409101YA0400X
MT642471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)