Provider Demographics
NPI:1023690575
Name:ARSENAULT, SHAWN L (CADC)
Entity type:Individual
Prefix:
First Name:SHAWN
Middle Name:L
Last Name:ARSENAULT
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:97 VILLAGE RD
Mailing Address - Street 2:
Mailing Address - City:STETSON
Mailing Address - State:ME
Mailing Address - Zip Code:04488-3148
Mailing Address - Country:US
Mailing Address - Phone:207-505-0774
Mailing Address - Fax:
Practice Address - Street 1:97 VILLAGE RD
Practice Address - Street 2:
Practice Address - City:STETSON
Practice Address - State:ME
Practice Address - Zip Code:04488-3148
Practice Address - Country:US
Practice Address - Phone:207-505-0774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-24
Last Update Date:2021-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECAC7326101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)