Provider Demographics
NPI:1992134316
Name:FLACK, ARNOLD RANDALL (CSAC)
Entity type:Individual
Prefix:
First Name:ARNOLD
Middle Name:RANDALL
Last Name:FLACK
Suffix:
Gender:M
Credentials:CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 CENTERVIEW DR
Mailing Address - Street 2:SUITE 150
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-3725
Mailing Address - Country:US
Mailing Address - Phone:336-834-9664
Mailing Address - Fax:336-834-9698
Practice Address - Street 1:3 CENTERVIEW DR
Practice Address - Street 2:SUITE 150
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-3725
Practice Address - Country:US
Practice Address - Phone:336-834-9664
Practice Address - Fax:336-834-9698
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-06
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)