Provider Demographics
NPI:1245760313
Name:ARNOLD, KRISTOPHER AARON (LICSW)
Entity Type:Individual
Prefix:
First Name:KRISTOPHER
Middle Name:AARON
Last Name:ARNOLD
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 S UNIVERSITY RD STE 202
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99206-6164
Mailing Address - Country:US
Mailing Address - Phone:509-475-1600
Mailing Address - Fax:208-625-2070
Practice Address - Street 1:325 S UNIVERSITY RD STE 202
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-6164
Practice Address - Country:US
Practice Address - Phone:509-475-1600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-12
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
IDLCSW-409201041C0700X
WASC607746901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health