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Provider Information for 1063404135


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Mr. MICHAEL CHARLES ARNOLD LIMHP LADC LPC


Sex: Male

NPI: 1063404135
Last Updated: 2016-09-29
Certification Date:

Details

NameValue
NPI1063404135
Enumeration Date2005-08-16
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 12035 Q ST
OMAHA, NE 68137-3542
United States

Phone: 402-991-0611 | Fax:402-991-6228
 
Primary Practice Address 12035 Q ST
OMAHA, NE 68137-3542
United States

Phone: 402-991-0611 | Fax:402-991-6228
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 101YA0400X - Counselor - Addiction (Substance Use Disorder)NELA DC 579
No 101YM0800X - Counselor - Mental HealthNE1481
Yes 101YM0800X - Counselor - Mental HealthNE697