Individual provider Active NPI

Annette Arnold, LLPC,CAAC,LBSW,ADS

  • Mental Health Counselor
  • Saint Clair Shores, MI
National Provider Identifier
1306154141
Registry record updated Sep 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6401010508 Issued in MI
Practice address
22777 Harper Ave
Suite 208a
Saint Clair Shores, MI 48080-1868
Phone
(313) 399-3712
Fax
(313) 521-9125
NPI assigned
Sep 14, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X C-01677 MI
Mental Health Counselor 101YM0800X 6401010508 MI Primary
Social Worker 104100000X 6802080312 MI

Addresses

Primary practice location

22777 Harper Ave
Suite 208a
Saint Clair Shores, MI 48080-1868

Mailing address

19217 Hickory St
Detroit, MI 48205-2236
Phone (313) 399-3712

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
C-01677MIMDAddiction (Substance Use Disorder) Counselor
6401010508MIMDMental Health Counselor
6802080312MIMDSocial Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1284422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284422400000",
    "number": "1306154141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19217 HICKORY ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482052236",
            "telephone_number": "313-399-3712",
            "fax_number": "313-521-9125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22777 HARPER AVE",
            "address_2": "SUITE 208A",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801868",
            "telephone_number": "313-399-3712",
            "fax_number": "313-521-9125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARNOLD",
        "first_name": "ANNETTE",
        "name_prefix": "Ms.",
        "credential": "LLPC,CAAC,LBSW,ADS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-14",
        "last_updated": "2010-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "C-01677",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401010508",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6802080312",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.