Thomas J. Butcher, M.A., LPC

Individual provider Active NPI Professional Counselor · East Lyme, CT

NPI 1497003016 · NPPES record last updated Aug 29, 2012

Key facts

NPI
1497003016
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
00508 (CT)
Practice address
315 Flanders Rd
Suite a
East Lyme, CT 06333-1711
Phone
(860) 739-8271
Fax
(860) 887-7109
NPI assigned
Aug 29, 2012
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
00508CTMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 00508 CT Yes

Addresses

Primary practice location

315 Flanders Rd
Suite a
East Lyme, CT 06333-1711

Mailing address

315 Flanders Rd
Suite a
East Lyme, CT 06333-1711
Phone (860) 739-8271

Other providers in East Lyme, CT

All providers in East Lyme, CT · Professional Counselor in Connecticut

Sources for this page

Verify at the official NPI Registry.