Provider Demographics
NPI:1689361537
Name:ARNOLD, AMANDA CAROL (LPC, NCC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:CAROL
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2210 E SHARPTAIL ST
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83646-7414
Mailing Address - Country:US
Mailing Address - Phone:925-209-4138
Mailing Address - Fax:
Practice Address - Street 1:2210 E SHARPTAIL ST
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83646-7414
Practice Address - Country:US
Practice Address - Phone:925-209-4138
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-20
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLPC-8293101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional