Provider Demographics
NPI:1528707015
Name:WARREN, AARON LEE (MS, LMFT)
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:LEE
Last Name:WARREN
Suffix:
Gender:M
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:CHARLES
Other - Middle Name:AARON
Other - Last Name:WARREN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3139 XENIA ST N
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-2923
Mailing Address - Country:US
Mailing Address - Phone:828-557-3540
Mailing Address - Fax:
Practice Address - Street 1:3139 XENIA ST N
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-2923
Practice Address - Country:US
Practice Address - Phone:828-557-3540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-02
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT4774106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLW650012941380Medicaid