Healthcare Provider Details

I. General information

NPI: 1629948500
Provider Name (Legal Business Name): JOLENE ARSENEAULT LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2025
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

636 BROAD ST
BLOOMFIELD NJ
07003-2802
US

IV. Provider business mailing address

636 BROAD ST
BLOOMFIELD NJ
07003-2802
US

V. Phone/Fax

Practice location:
  • Phone: 607-759-7577
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC06525500
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: