MEDICARE: SHAWN L ARSENAULT CADC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	CAC7326	ME

General Provider Information

NPI Number	:	1023690575
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAWN L ARSENAULT CADC

Provider Business Mailing Address
First Line	:	97 VILLAGE RD
Second Line	:
City	:	STETSON
State	:	ME
Zip	:	04488-3148
Country	:	US
Telephone Number	:	207-505-0774
Fax Number	:

Provider Business Practice Location Address
First Line	:	97 VILLAGE RD
Second Line	:
City	:	STETSON
State	:	ME
Zip	:	04488-3148
Country	:	US
Telephone Number	:	207-505-0774
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/24/2021
Last Update Date	:	04/24/2021

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