Provider Demographics
NPI:1609256957
Name:NOTIS, THEODORE (TT&S)
Entity Type:Individual
Prefix:
First Name:THEODORE
Middle Name:
Last Name:NOTIS
Suffix:
Gender:M
Credentials:TT&S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 CONCORDIA DR
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01830-2062
Mailing Address - Country:US
Mailing Address - Phone:978-373-3086
Mailing Address - Fax:978-469-0486
Practice Address - Street 1:6 CONCORDIA DR
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-2062
Practice Address - Country:US
Practice Address - Phone:978-373-3086
Practice Address - Fax:978-469-0486
Is Sole Proprietor?:No
Enumeration Date:2015-06-02
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker