Provider Demographics
NPI:1457009854
Name:SCAGGS, THOMAS ANDREW
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:ANDREW
Last Name:SCAGGS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1230 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01850-1291
Mailing Address - Country:US
Mailing Address - Phone:978-998-7260
Mailing Address - Fax:
Practice Address - Street 1:1230 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01850-1291
Practice Address - Country:US
Practice Address - Phone:978-998-7260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-15
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health