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General NPI Number Information
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NPI Number | 1841764727
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Entity Type | Individual
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Provider Name | SAMANTHA ARNOLD LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/14/2019
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Last Update Date | 02/10/2021
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Provider Practice Location Address
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Address Line | 1223 S RAILROAD AVE
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City | SUGAR CITY
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State | ID
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Zip | 83448-5072
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Country | US
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Telephone | 208-359-0519
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Fax | 208-359-2493
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Provider Business Mailing Address
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Address Line | PO BOX 4789
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City | POCATELLO
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State | ID
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Zip | 83205-4789
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Country | US
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Telephone | 208-359-0519
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Fax | 208-359-2493
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW-38266
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License Number State | ID
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