Healthcare Provider Details

I. General information

NPI: 1982107793
Provider Name (Legal Business Name): NICOLE L ARNOLD MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2018
Last Update Date: 03/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

731 MAIN ST
MONROE CT
06468-2872
US

IV. Provider business mailing address

57 RIVERSIDE DR
FAIRFIELD CT
06824-6210
US

V. Phone/Fax

Practice location:
  • Phone: 203-942-1116
  • Fax:
Mailing address:
  • Phone: 203-942-1116
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: