Provider Demographics
NPI:1306046933
Name:MOTT, THOMAS JAMES (MS LPC)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:JAMES
Last Name:MOTT
Suffix:
Gender:M
Credentials:MS LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 LUCERNE ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGVALE
Mailing Address - State:ME
Mailing Address - Zip Code:04083-1713
Mailing Address - Country:US
Mailing Address - Phone:802-236-5111
Mailing Address - Fax:
Practice Address - Street 1:4 BACK RIVER RD
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-4404
Practice Address - Country:US
Practice Address - Phone:603-742-1373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-22
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0928101YA0400X
GALPC011164101YP2500X
MECC4301101YP2500X
SC8164101YP2500X
NH1062101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional