Provider Demographics
NPI:1700403458
Name:ARSENAULT PSYCHOLOGICAL SERVICES, LLC
Entity Type:Organization
Organization Name:ARSENAULT PSYCHOLOGICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ARSENAULT
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, HSP
Authorized Official - Phone:423-264-2394
Mailing Address - Street 1:100 CHEROKEE BLVD STE 301
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37405-3886
Mailing Address - Country:US
Mailing Address - Phone:423-264-2394
Mailing Address - Fax:
Practice Address - Street 1:100 CHEROKEE BLVD STE 301
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37405-3886
Practice Address - Country:US
Practice Address - Phone:423-264-2394
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-29
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health