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General NPI Number Information
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NPI Number | 1053733360
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Entity Type | Individual
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Provider Name | ARTHUR LEE BENNETT JR. PH.D
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Gender | Male
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Dates
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Enumeration Date | 01/07/2014
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Last Update Date | 10/10/2025
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Provider Practice Location Address
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Address Line | 3098 PIEDMONT RD NE STE 102
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City | ATLANTA
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State | GA
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Zip | 30305-2600
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Country | US
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Telephone | 561-513-0403
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Fax |
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Provider Business Mailing Address
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Address Line | 542 AMHERST ST STE B
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City | NASHUA
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State | NH
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Zip | 03063-1016
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY004477
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number |
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License Number State |
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