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General NPI Number Information
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NPI Number | 1306154141
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Entity Type | Individual
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Provider Name | ANNETTE ARNOLD LLPC,CAAC,LBSW,ADS
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Gender | Female
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Dates
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Enumeration Date | 09/14/2010
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Last Update Date | 09/14/2010
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Provider Practice Location Address
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Address Line | 22777 HARPER AVE SUITE 208A
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City | SAINT CLAIR SHORES
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State | MI
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Zip | 48080-1868
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Country | US
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Telephone | 313-399-3712
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Fax | 313-521-9125
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Provider Business Mailing Address
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Address Line | 19217 HICKORY ST
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City | DETROIT
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State | MI
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Zip | 48205-2236
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Country | US
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Telephone | 313-399-3712
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Fax | 313-521-9125
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | C-01677
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 6401010508
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 6802080312
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License Number State | MI
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