Provider Demographics
NPI:1851452502
Name:ARNOLD, KRISTEN (MSW LICENSED CLINICA)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:MSW LICENSED CLINICA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:FOXBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02035-2328
Mailing Address - Country:US
Mailing Address - Phone:617-259-8721
Mailing Address - Fax:
Practice Address - Street 1:28 MARKET ST
Practice Address - Street 2:
Practice Address - City:FOXBORO
Practice Address - State:MA
Practice Address - Zip Code:02035-2328
Practice Address - Country:US
Practice Address - Phone:617-259-8721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1146101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA042611055OtherTAX ID
MA1303287Medicaid
MA1303287OtherMBHP
MA703136OtherTUFTS
MAM18633OtherBCBC
MANP01332OtherBMC
MA1004745OtherNHP