Provider Demographics
NPI:1174963748
Name:ARNOLD, BRENDA J (MS,NCC,LPCC)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:J
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:MS,NCC,LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6331 HIDDEN LN
Mailing Address - Street 2:
Mailing Address - City:SOUTH HAVEN
Mailing Address - State:MN
Mailing Address - Zip Code:55382-4555
Mailing Address - Country:US
Mailing Address - Phone:320-492-7939
Mailing Address - Fax:
Practice Address - Street 1:6331 HIDDEN LN
Practice Address - Street 2:
Practice Address - City:SOUTH HAVEN
Practice Address - State:MN
Practice Address - Zip Code:55382-4555
Practice Address - Country:US
Practice Address - Phone:320-492-7939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-27
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC00577101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional