Provider Demographics
NPI:1801193677
Name:ARNOLD, TINA R (MS, NCC, LPC-INTERN)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:R
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:MS, NCC, LPC-INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1204 BENT OAKS #200
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76205
Mailing Address - Country:US
Mailing Address - Phone:940-387-3450
Mailing Address - Fax:469-574-5166
Practice Address - Street 1:1204 BENT OAKS CT STE 200
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-8000
Practice Address - Country:US
Practice Address - Phone:940-387-3450
Practice Address - Fax:469-574-5166
Is Sole Proprietor?:No
Enumeration Date:2011-02-14
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
269432101Y00000X
TX66882101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor