Provider Demographics
NPI:1932876935
Name:ARNOLD, KRISTILYN HILDA (CADC I , CRM II, PSS)
Entity type:Individual
Prefix:
First Name:KRISTILYN
Middle Name:HILDA
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:CADC I , CRM II, PSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 JACKSON ST SE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97322-3244
Mailing Address - Country:US
Mailing Address - Phone:541-981-8481
Mailing Address - Fax:541-250-5178
Practice Address - Street 1:1100 JACKSON ST SE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97322-3244
Practice Address - Country:US
Practice Address - Phone:541-981-8481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-26
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR21-07-10188101YA0400X
OR107005175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)