Provider Demographics
NPI:1083670491
Name:KERN, THOMAS MICHAEL (MS,CAC,LPC)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:MICHAEL
Last Name:KERN
Suffix:
Gender:M
Credentials:MS,CAC,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 W GORE RD
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16509-3625
Mailing Address - Country:US
Mailing Address - Phone:814-838-2282
Mailing Address - Fax:814-838-1091
Practice Address - Street 1:2525 W 26TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506-3254
Practice Address - Country:US
Practice Address - Phone:814-838-2282
Practice Address - Fax:814-838-1091
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACAC NUMBER 0808101YA0400X
PAPC0001391101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional