Provider Demographics
NPI:1518518505
Name:ARNOLD, AMANDA (MA, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1804 AVENUE P 1/2
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77340-4326
Mailing Address - Country:US
Mailing Address - Phone:731-331-3544
Mailing Address - Fax:
Practice Address - Street 1:9191 PINECROFT DR
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77380-2796
Practice Address - Country:US
Practice Address - Phone:731-331-3544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-22
Last Update Date:2019-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX78409101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional