Provider Demographics
NPI:1144673831
Name:ARNOLD, THOMAS (LCDC)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:
Last Name:ARNOLD
Suffix:
Gender:M
Credentials:LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 108
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:TX
Mailing Address - Zip Code:75751-0108
Mailing Address - Country:US
Mailing Address - Phone:903-292-5108
Mailing Address - Fax:903-292-5109
Practice Address - Street 1:18830 FM 315
Practice Address - Street 2:
Practice Address - City:PALESTINE
Practice Address - State:TX
Practice Address - Zip Code:75803-4108
Practice Address - Country:US
Practice Address - Phone:903-292-5108
Practice Address - Fax:903-292-5109
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-18
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12966101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)