Provider Demographics
NPI:1629653019
Name:ARNETT, MICHAELLA
Entity Type:Individual
Prefix:
First Name:MICHAELLA
Middle Name:
Last Name:ARNETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2315 ZLATEN DR APT B304
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80504-2009
Mailing Address - Country:US
Mailing Address - Phone:808-599-0650
Mailing Address - Fax:
Practice Address - Street 1:3483 BARKWOOD DR
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:CO
Practice Address - Zip Code:80534-8275
Practice Address - Country:US
Practice Address - Phone:720-263-2531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-17
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1041C0700X
CO1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical