Organization Active NPI

Thomas J. Clucas, PHD, P.C.

  • Psychologist
  • Missoula, MT
National Provider Identifier
1801066345
Registry record updated Apr 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
186 Issued in MT
Legal business name
THOMAS J. CLUCAS, PHD, P.C.
Practice address
125 Bank St Ste 310
Missoula, MT 59802-4413
Phone
(406) 549-7325
NPI assigned
Mar 11, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Thomas J. Clucas, PHD
Title
Director
Phone
(406) 549-7325

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 186 MT Primary

Addresses

Primary practice location

125 Bank St Ste 310
Missoula, MT 59802-4413

Mailing address

125 Bank St Ste 310
Missoula, MT 59802-4413
Phone (406) 549-7325

Other identifiers 2

IdentifierTypeStateIssuer
1083763643MedicaidMT
51981OtherMTBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Locations

125 Bank St
Ste 310
Missoula, MT 59802
Phone (406) 282-4402

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1205193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207785600000",
    "number": "1801066345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 BANK ST STE 310",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024413",
            "telephone_number": "406-549-7325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 BANK ST STE 310",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024413",
            "telephone_number": "406-549-7325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS J. CLUCAS, PHD, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-11",
        "last_updated": "2008-04-10",
        "status": "A",
        "authorized_official_last_name": "CLUCAS",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "406-549-7325",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "MT",
            "license": "186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1083763643",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "51981",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.