Provider Demographics
NPI:1538320155
Name:ARNOLD, TAMEKA KENYETTA (LMSW)
Entity Type:Individual
Prefix:
First Name:TAMEKA
Middle Name:KENYETTA
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22777 HARPER AVE
Mailing Address - Street 2:SUITE 208 A
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48080-1868
Mailing Address - Country:US
Mailing Address - Phone:586-945-6177
Mailing Address - Fax:
Practice Address - Street 1:22777 HARPER AVE
Practice Address - Street 2:SUITE 208 A
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48080-1868
Practice Address - Country:US
Practice Address - Phone:586-945-6177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-17
Last Update Date:2012-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010859611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical