Basic Information
| Provider Information | |||||||||
| NPI: | 1801890728 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ARNFIELD | ||||||||
| FirstName: | LAURA | ||||||||
| MiddleName: | |||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1111 | ||||||||
| Address2: | |||||||||
| City: | KINGSPORT | ||||||||
| State: | TN | ||||||||
| PostalCode: | 376621111 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4235423819 | ||||||||
| FaxNumber: | 4237077706 | ||||||||
| Practice Location | |||||||||
| Address1: | 108 E MAIN ST | ||||||||
| Address2: | |||||||||
| City: | KINGSPORT | ||||||||
| State: | TN | ||||||||
| PostalCode: | 376604257 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4235781541 | ||||||||
| FaxNumber: | 4237077706 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2005 | ||||||||
| LastUpdateDate: | 11/17/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | LSW000003002 | TN | Y | Behavioral Health & Social Service Providers | Social Worker |
ID Information
| ID | Type | State | Issuer | Description | 3927825 | 05 | TN | MEDICAID |