Provider Demographics
NPI:1447874854
Name:MCCANN, AIMEE RENEE (MSW, LISW-S)
Entity type:Individual
Prefix:
First Name:AIMEE
Middle Name:RENEE
Last Name:MCCANN
Suffix:
Gender:F
Credentials:MSW, LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6415 BEAUMONT SQ
Mailing Address - Street 2:
Mailing Address - City:LEWIS CENTER
Mailing Address - State:OH
Mailing Address - Zip Code:43035-8164
Mailing Address - Country:US
Mailing Address - Phone:740-360-2329
Mailing Address - Fax:
Practice Address - Street 1:6415 BEAUMONT SQ
Practice Address - Street 2:
Practice Address - City:LEWIS CENTER
Practice Address - State:OH
Practice Address - Zip Code:43035-8164
Practice Address - Country:US
Practice Address - Phone:740-360-2329
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-01
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.00058751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical