Provider Demographics
NPI:1760081012
Name:ARNOLD, HEATHER (LCSW)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
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 1:4305 BAKER SCHOOL HOUSE RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATUS
Mailing Address - State:NY
Mailing Address - Zip Code:13040-2201
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4305 BAKER SCHOOL HOUSE RD
Practice Address - Street 2:
Practice Address - City:CINCINNATUS
Practice Address - State:NY
Practice Address - Zip Code:13040-2201
Practice Address - Country:US
Practice Address - Phone:607-283-3374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-19
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY106576104100000X
NY0974081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker