Provider Demographics
NPI:1912939190
Name:ARNOLD, BRUCE ROBERT (LCSW)
Entity Type:Individual
Prefix:MR
First Name:BRUCE
Middle Name:ROBERT
Last Name:ARNOLD
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 QUARTERDECK
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28562-3800
Mailing Address - Country:US
Mailing Address - Phone:252-671-3539
Mailing Address - Fax:
Practice Address - Street 1:2801 NEUSE BLVD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-2838
Practice Address - Country:US
Practice Address - Phone:252-636-6007
Practice Address - Fax:252-672-0009
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2013-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0019491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6002252Medicaid
NC11981OtherBLUE CROSS/BLUE SHIELD