Provider Demographics
NPI:1467332171
Name:KOZUSHKO, AIMEE NOELLE (LMSW-T)
Entity type:Individual
Prefix:
First Name:AIMEE
Middle Name:NOELLE
Last Name:KOZUSHKO
Suffix:
Gender:F
Credentials:LMSW-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1009 N KOKOMO AVE
Mailing Address - Street 2:
Mailing Address - City:DERBY
Mailing Address - State:KS
Mailing Address - Zip Code:67037-1830
Mailing Address - Country:US
Mailing Address - Phone:316-201-6047
Mailing Address - Fax:
Practice Address - Street 1:8100 E 22ND ST N
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226-2350
Practice Address - Country:US
Practice Address - Phone:316-201-6047
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-03
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14389T104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker