Provider Demographics
NPI:1700305729
Name:ARNOLD, BRANDIE RENEE (LPC)
Entity Type:Individual
Prefix:
First Name:BRANDIE
Middle Name:RENEE
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:BRANDIE
Other - Middle Name:RENEE
Other - Last Name:HILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2607 CADDO ST STE 6
Mailing Address - Street 2:
Mailing Address - City:ARKADELPHIA
Mailing Address - State:AR
Mailing Address - Zip Code:71923-5307
Mailing Address - Country:US
Mailing Address - Phone:870-230-8217
Mailing Address - Fax:870-230-8201
Practice Address - Street 1:3111 S 70TH ST
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-5017
Practice Address - Country:US
Practice Address - Phone:479-452-6650
Practice Address - Fax:479-452-5847
Is Sole Proprietor?:No
Enumeration Date:2017-09-11
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR331180453Medicaid