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Provider Information for 1306050158


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Mr. LUKE ALLEN ARNOLD M.A, LMFT, NCC


Sex: Male

NPI: 1306050158
Last Updated: 2007-07-09
Certification Date:

Details

NameValue
NPI1306050158
Enumeration Date2007-05-10
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 58 SANTA MARIA DR
EDGEWOOD, NM 87015-9700
United States

Phone: | Fax:
 
Primary Practice Address 1218 GRIEGOS RD NW
ALBUQUERQUE, NM 87107-3752
United States

Phone: 505-345-8471 | Fax:505-342-5414
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDNM44805268
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 106H00000X - Marriage & Family Therapist NM0090501
No 106H00000X - Marriage & Family Therapist CA41945