MEDICARE: JOAN G ARNOLD LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	1871	TN
2	101YM0800X	Mental Health Counselor	MH12639	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4121022	OTHER	TN	BLUE CROSS/ BLUE SHIELD

General Provider Information

NPI Number	:	1194740274
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOAN G ARNOLD LMHC

Provider Business Mailing Address
First Line	:	4740 N STATE ROAD 7
Second Line	:	SUITE 201
City	:	LAUDERDALE LAKES
State	:	FL
Zip	:	33319-5839
Country	:	US
Telephone Number	:	954-486-4005
Fax Number	:	954-497-3857

Provider Business Practice Location Address
First Line	:	2900 W PROSPECT RD
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-2519
Country	:	US
Telephone Number	:	954-731-5100
Fax Number	:	954-498-3857

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	12/13/2017

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