Provider Demographics
NPI:1306324181
Name:ARNOLD, TRAVIS W (MSW, LICSW, CDP)
Entity type:Individual
Prefix:MR
First Name:TRAVIS
Middle Name:W
Last Name:ARNOLD
Suffix:
Gender:M
Credentials:MSW, LICSW, CDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9023 N WARREN ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-5179
Mailing Address - Country:US
Mailing Address - Phone:509-216-3995
Mailing Address - Fax:
Practice Address - Street 1:9023 N WARREN ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-5179
Practice Address - Country:US
Practice Address - Phone:509-216-3995
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-02
Last Update Date:2018-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP60081305101YA0400X
WALW602869821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)