Provider Demographics
NPI:1629097134
Name:ARNOLD, MARIE GENE (LCSW)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:GENE
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2746 FAIRLEIGH TER
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64506-2870
Mailing Address - Country:US
Mailing Address - Phone:816-279-3351
Mailing Address - Fax:816-279-3311
Practice Address - Street 1:2746 FAIRLEIGH TER
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-2870
Practice Address - Country:US
Practice Address - Phone:816-279-3351
Practice Address - Fax:816-279-3311
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001030594101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO33576022OtherBLUE CROSS BLUE SHIELD KC