Provider Demographics
NPI:1811167034
Name:BURD-ARNOLD, ALICEN J (LPC, MED)
Entity type:Individual
Prefix:MISS
First Name:ALICEN
Middle Name:J
Last Name:BURD-ARNOLD
Suffix:
Gender:F
Credentials:LPC, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:918 BLUE MOUNTAIN DR
Mailing Address - Street 2:
Mailing Address - City:WALNUTPORT
Mailing Address - State:PA
Mailing Address - Zip Code:18088-9415
Mailing Address - Country:US
Mailing Address - Phone:843-415-2100
Mailing Address - Fax:
Practice Address - Street 1:918 BLUE MOUNTAIN DR
Practice Address - Street 2:
Practice Address - City:WALNUTPORT
Practice Address - State:PA
Practice Address - Zip Code:18088-9415
Practice Address - Country:US
Practice Address - Phone:843-415-2100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-04
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA003143101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional