Healthcare Provider Details

I. General information

NPI: 1003752080
Provider Name (Legal Business Name): BOLD BEHAVIORAL HEALTH, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2026
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 OFFICE PARK RD STE 221
WEST DES MOINES IA
50265-2548
US

IV. Provider business mailing address

514 TWITCHELL HILL RD
SHAFTSBURY VT
05262-9252
US

V. Phone/Fax

Practice location:
  • Phone: 515-207-9693
  • Fax:
Mailing address:
  • Phone: 515-207-9693
  • Fax: 515-512-1502

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: SCOTT ARNO
Title or Position: OWNER
Credential: PA-C
Phone: 315-261-8875