Provider Demographics
NPI:1053733360
Name:BENNETT, ARTHUR LEE JR (PHD)
Entity type:Individual
Prefix:MR
First Name:ARTHUR
Middle Name:LEE
Last Name:BENNETT
Suffix:JR
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 MANCHESTER ST STE 5A
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-5101
Mailing Address - Country:US
Mailing Address - Phone:603-606-9357
Mailing Address - Fax:603-606-9357
Practice Address - Street 1:117 MANCHESTER ST STE 5A
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-5101
Practice Address - Country:US
Practice Address - Phone:603-606-9357
Practice Address - Fax:603-217-2075
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-07
Last Update Date:2024-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
305S00000X
GAPSY004477103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No305S00000XManaged Care OrganizationsPoint of Service