MEDICARE: ELIZABETH SHANNON ARNOLD LPC, NCC

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	101YM0800X	Mental Health Counselor	19553	TX

General Provider Information

NPI Number	:	1396901328
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH SHANNON ARNOLD LPC, NCC

Provider Business Mailing Address
First Line	:	4441 SACRED ARROW DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78735-6362
Country	:	US
Telephone Number	:	512-633-5474
Fax Number	:

Provider Business Practice Location Address
First Line	:	1825 FORTVIEW RD
Second Line	:	STE. 112F
City	:	AUSTIN
State	:	TX
Zip	:	78704-7657
Country	:	US
Telephone Number	:	512-633-5474
Fax Number	:

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

Provider Enumeration Date	:	07/29/2008
Last Update Date	:	07/29/2008

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