Healthcare Provider Details

I. General information

NPI: 1699111419
Provider Name (Legal Business Name): MATTHEW D. ARNZEN LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2013
Last Update Date: 12/18/2024
Certification Date: 12/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4339 WINSTON AVE
COVINGTON KY
41015-1739
US

IV. Provider business mailing address

600 GREENUP ST
COVINGTON KY
41011-2524
US

V. Phone/Fax

Practice location:
  • Phone: 859-835-2573
  • Fax:
Mailing address:
  • Phone: 859-307-3010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number5022
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: