Provider Demographics
NPI:1114347721
Name:CHRISTY, NICK (MSED, NCC, LPC)
Entity Type:Individual
Prefix:
First Name:NICK
Middle Name:
Last Name:CHRISTY
Suffix:
Gender:M
Credentials:MSED, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 WEAVER DR
Mailing Address - Street 2:
Mailing Address - City:GLENSHAW
Mailing Address - State:PA
Mailing Address - Zip Code:15116-1425
Mailing Address - Country:US
Mailing Address - Phone:412-956-5468
Mailing Address - Fax:
Practice Address - Street 1:200 WEAVER DR
Practice Address - Street 2:
Practice Address - City:GLENSHAW
Practice Address - State:PA
Practice Address - Zip Code:15116-1425
Practice Address - Country:US
Practice Address - Phone:412-956-5468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-22
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC007386101YP2500X
PA4280748101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool