Provider Demographics
NPI:1053180034
Name:ARSENAULT, PETER JOHN (PSYD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:JOHN
Last Name:ARSENAULT
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 THICKET ST
Mailing Address - Street 2:
Mailing Address - City:OCEAN VIEW
Mailing Address - State:NJ
Mailing Address - Zip Code:08230-1638
Mailing Address - Country:US
Mailing Address - Phone:609-231-6513
Mailing Address - Fax:
Practice Address - Street 1:549 NEW RD STE G
Practice Address - Street 2:
Practice Address - City:SOMERS POINT
Practice Address - State:NJ
Practice Address - Zip Code:08244-2075
Practice Address - Country:US
Practice Address - Phone:609-601-2479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-01
Last Update Date:2024-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00725200103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist