Provider Demographics
NPI:1538221908
Name:THOMAS, WINFIELD NORMAN (LADC)
Entity type:Individual
Prefix:
First Name:WINFIELD
Middle Name:NORMAN
Last Name:THOMAS
Suffix:
Gender:M
Credentials:LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1160 TAYLOR RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO BEND
Mailing Address - State:VT
Mailing Address - Zip Code:05842-4407
Mailing Address - Country:US
Mailing Address - Phone:802-533-9238
Mailing Address - Fax:
Practice Address - Street 1:1160 TAYLOR RD
Practice Address - Street 2:
Practice Address - City:GREENSBORO BEND
Practice Address - State:VT
Practice Address - Zip Code:05842-4407
Practice Address - Country:US
Practice Address - Phone:802-533-9238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT000002101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)