Provider Demographics
NPI:1841733631
Name:ARNOLD, SAMANTHA (LPC)
Entity type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:364 KIM TRL
Mailing Address - Street 2:
Mailing Address - City:LAKE ZURICH
Mailing Address - State:IL
Mailing Address - Zip Code:60047-2146
Mailing Address - Country:US
Mailing Address - Phone:847-502-2247
Mailing Address - Fax:
Practice Address - Street 1:364 KIM TRL
Practice Address - Street 2:
Practice Address - City:LAKE ZURICH
Practice Address - State:IL
Practice Address - Zip Code:60047-2146
Practice Address - Country:US
Practice Address - Phone:847-502-2247
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-28
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.011576101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health