Healthcare Provider Details

I. General information

NPI: 1215186234
Provider Name (Legal Business Name): PETER MATTHEW ARNOLD-ROBICHAUX LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: PETER MATTHEW ROBICHAUX LCSW

II. Dates (important events)

Enumeration Date: 09/15/2008
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13815 PROFESSIONAL CENTER DR STE 100
HUNTERSVILLE NC
28078-7951
US

IV. Provider business mailing address

PO BOX 60447
CHARLOTTE NC
28260-0447
US

V. Phone/Fax

Practice location:
  • Phone: 704-384-1320
  • Fax: 704-316-3138
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149015882
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number390200000X
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC15345
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: