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Individual

AIMEE STAILEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
400 LOCUST AVE STE 4, CHARLOTTESVILLE, VA 22902-4858
(270) 484-5797
Mailing address
2475 REDOUBT AVE, PENSACOLA, FL 32507-2769
(270) 484-5797

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
34006830A
IN
101YS0200X
School Counselor
Primary
34006830A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000846130
ANTHEM BCBS
IN
Enumeration date
11/15/2013
Last updated
11/19/2021
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