Provider Demographics
NPI:1023691342
Name:GALLOWAY, AARON (LPCC, NCC, EMDR-II)
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:GALLOWAY
Suffix:
Gender:M
Credentials:LPCC, NCC, EMDR-II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2090 GRAPE AVE
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-2338
Mailing Address - Country:US
Mailing Address - Phone:319-361-9234
Mailing Address - Fax:
Practice Address - Street 1:2503 WALNUT ST
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-5748
Practice Address - Country:US
Practice Address - Phone:319-361-9234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-04
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC0017052101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty