Individual provider Active NPI

Adam David Arsenault, PSY.D., HSP

  • Psychologist
  • Chattanooga, TN
National Provider Identifier
1508089681
Registry record updated Jun 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3416 Issued in TN
Practice address
100 Cherokee Blvd Ste 301
Chattanooga, TN 37405-3886
Phone
(423) 264-2394
NPI assigned
Apr 10, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Mental Health Counselor 101YM0800X
Case Manager/Care Coordinator 171M00000X
Psychologist 103T00000X 3416 TN Primary

Addresses

Primary practice location

100 Cherokee Blvd Ste 301
Chattanooga, TN 37405-3886

Mailing address

100 Cherokee Blvd Ste 301
Chattanooga, TN 37405-3886
Phone (423) 264-2394

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3416TNMDOccupational Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1508089681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CHEROKEE BLVD STE 301",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374053886",
            "telephone_number": "423-264-2394",
            "fax_number": "423-214-3415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CHEROKEE BLVD STE 301",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374053886",
            "telephone_number": "423-264-2394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARSENAULT",
        "first_name": "ADAM",
        "middle_name": "DAVID",
        "credential": "PSY.D., HSP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TN",
            "license": "3416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.