Provider Demographics
NPI:1679099618
Name:NIENSTEDT DICKSON, AIMEE LOU (LCSW, LCSW, PMH-C)
Entity type:Individual
Prefix:
First Name:AIMEE
Middle Name:LOU
Last Name:NIENSTEDT DICKSON
Suffix:
Gender:F
Credentials:LCSW, LCSW, PMH-C
Other - Prefix:MRS
Other - First Name:AIMEE
Other - Middle Name:
Other - Last Name:NIENSTEDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:3208 SAGE GRASS CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65202-5624
Mailing Address - Country:US
Mailing Address - Phone:816-853-7857
Mailing Address - Fax:
Practice Address - Street 1:1511 CHRISTY DR
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65101-2854
Practice Address - Country:US
Practice Address - Phone:573-632-2777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-22
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20170300791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical