Individual provider Active NPI

Robert Arnold, ED.D., M.A., BCPC, C

  • Counselor
  • Largo, FL
National Provider Identifier
1740629328
Registry record updated Jun 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
IMH1504 Issued in FL
Practice address
10204 Seminole Island Dr
Largo, FL 33773-4124
Phone
(727) 417-6517
Fax
(727) 397-2168
NPI assigned
Jun 18, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2013

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X IMH1504 FL Primary
Cognitive & Behavioral Psychologist 103TB0200X IMH1504 FL
Clinical Child & Adolescent Psychologist 103TC2200X IMH1504 FL
Group Psychotherapy Psychologist 103TP2701X IMH1504 FL

Addresses

Primary practice location

10204 Seminole Island Dr
Largo, FL 33773-4124

Mailing address

10204 Seminole Island Dr
Largo, FL 33773-4124
Phone (727) 417-6517

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
IMH1504FLMDClinical Child & Adolescent Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1371513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371513600000",
    "number": "1740629328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10204 SEMINOLE ISLAND DR",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337734124",
            "telephone_number": "727-417-6517",
            "fax_number": "727-397-2168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10204 SEMINOLE ISLAND DR",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337734124",
            "telephone_number": "727-417-6517",
            "fax_number": "727-397-2168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARNOLD",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "ED.D., M.A., BCPC, C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-18",
        "last_updated": "2013-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "FL",
            "license": "IMH1504",
            "primary": true
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "FL",
            "license": "IMH1504",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "FL",
            "license": "IMH1504",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "FL",
            "license": "IMH1504",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2013; 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.