Provider Demographics
NPI:1518115328
Name:MORTENSEN, AIMEE LYNN (CCMHC, CST, NCC)
Entity type:Individual
Prefix:MS
First Name:AIMEE
Middle Name:LYNN
Last Name:MORTENSEN
Suffix:
Gender:F
Credentials:CCMHC, CST, NCC
Other - Prefix:MRS
Other - First Name:AIMEE
Other - Middle Name:LYNN
Other - Last Name:FRANCOM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCMHC, NCC
Mailing Address - Street 1:3098 W EXECUTIVE PKWY STE 280
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-4949
Mailing Address - Country:US
Mailing Address - Phone:801-404-3069
Mailing Address - Fax:385-250-2152
Practice Address - Street 1:3098 W EXECUTIVE PKWY STE 280
Practice Address - Street 2:
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-4949
Practice Address - Country:US
Practice Address - Phone:801-404-3069
Practice Address - Fax:801-206-3344
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-04
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT54053956009101YP2500X
UT5405395-6004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional