Provider Demographics
NPI:1245806728
Name:THOMAS BUTTS, PC
Entity Type:Organization
Organization Name:THOMAS BUTTS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:BUTTS
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:814-404-7600
Mailing Address - Street 1:110 SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17837-1864
Mailing Address - Country:US
Mailing Address - Phone:814-404-7600
Mailing Address - Fax:
Practice Address - Street 1:23 N DERR DR STE 26
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837-1324
Practice Address - Country:US
Practice Address - Phone:814-404-7600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-03
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty