MR. THOMAS BERNARD PETTUS LLPC LBS.W. NPI 1861503112

NPI Information

  • NPI: 1861503112
  • Provider Name: MR. THOMAS BERNARD PETTUS, LLPC, LBS.W.
  • Classification: Counselor - 101Y00000X
  • Entity Type: Individual
  • Address: 25153 LINDENWOOD LN
    SOUTHFIELD, MI
    ZIP 48033
  • Phone: (313) 702-1459

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NPI Details

MR. Thomas Bernard Pettus, LLPC, LBS.W. is a counselor in Southfield, MI. The provider is a provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification. MR. Thomas Bernard Pettus, LLPC, LBS.W. NPI is 1861503112. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

25153 LINDENWOOD LN
SOUTHFIELD, MI
ZIP 48033-189
Phone: (313) 702-1459

The enumeration date for this NPI number is 8/31/2006 and was last updated on 6/25/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1104100000XSocial Worker6802061866MICHIGANNo
2101Y00000XCounselor6401008172MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
16401008172OTHERMICHIGANST OF MI-COUNSELING LICENSE
26801061866OTHERMICHIGANSTATE LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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