Provider Demographics
NPI:1528245859
Name:GARBETT, THOMAS C (EDD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:C
Last Name:GARBETT
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 HICKORY LN
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-2845
Mailing Address - Country:US
Mailing Address - Phone:413-253-9894
Mailing Address - Fax:141-325-3989
Practice Address - Street 1:14 HICKORY LN
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-2845
Practice Address - Country:US
Practice Address - Phone:413-253-9894
Practice Address - Fax:141-325-3989
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-29
Last Update Date:2016-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6960103G00000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA6960OtherLIC PSY PROVIDER