Doctor Name: | THOMAS J. BUTCHER |
NPI Number: | 1497003016 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.A., LPC |
License Number: | 00508 |
Business Practice Address: | 315 Flanders Rd Suite A East Lyme, CT - 063331711 |
Business Phone Number: | 8607398271 |
Business Fax Number: | 8608877109 |
Mailing Address: | 315 Flanders Rd, Suite A EAST LYME |
State: | CT |
Postal Code: | 063331711 |
Phone Number: | 8607398271 |
Fax Number: | 8608877109 |
NPI Enumeration Date: | 08/29/2012 |
NPI Last Update Date: | 08/29/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 00508 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |