Healthcare Provider Details

I. General information

NPI: 1487348116
Provider Name (Legal Business Name): BRANDI A ARNOLD LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BRANDI A BENTLEY

II. Dates (important events)

Enumeration Date: 06/06/2023
Last Update Date: 08/16/2026
Certification Date: 08/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10632 W EXCALIBUR ST
BOISE ID
83713-5180
US

IV. Provider business mailing address

10632 W EXCALIBUR ST
BOISE ID
83713-5180
US

V. Phone/Fax

Practice location:
  • Phone: 208-447-7589
  • Fax:
Mailing address:
  • Phone: 208-447-7589
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number8331564
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: