Provider Demographics
NPI:1821325762
Name:ARNOLD, JEAN GARRITY (LMFT)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:GARRITY
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:JEAN
Other - Middle Name:GARRITY
Other - Last Name:ARNOLD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:72 N SMITH ST
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067-5047
Mailing Address - Country:US
Mailing Address - Phone:847-530-0484
Mailing Address - Fax:
Practice Address - Street 1:675 N NORTH CT
Practice Address - Street 2:SUITE 250
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60067-8157
Practice Address - Country:US
Practice Address - Phone:847-496-5529
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-13
Last Update Date:2015-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL166.000774106H00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL12389525OtherCAQH