Healthcare Provider Details

I. General information

NPI: 1124936307
Provider Name (Legal Business Name): ALICIA ARNZEN MARTINEC LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ALICIA MARIE ARNZEN

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

338 BROADWAY ST
CAPE GIRARDEAU MO
63701-7367
US

IV. Provider business mailing address

3294 COUNTY ROAD 318
CAPE GIRARDEAU MO
63701-9130
US

V. Phone/Fax

Practice location:
  • Phone: 682-622-9561
  • Fax:
Mailing address:
  • Phone: 682-622-9561
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number14992
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2022013696
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: