Healthcare Provider Details

I. General information

NPI: 1427975986
Provider Name (Legal Business Name): JOHN ARNOLD
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2026
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 38TH ST STE 100E
BOULDER CO
80301-2624
US

IV. Provider business mailing address

3434 47TH ST STE 130
BOULDER CO
80301-1802
US

V. Phone/Fax

Practice location:
  • Phone: 720-500-5482
  • Fax:
Mailing address:
  • Phone: 703-402-2462
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPCC.0023946
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: