Provider Demographics
NPI:1144201112
Name:CARDOT, TINA LORRAINE (MS, LPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:TINA
Middle Name:LORRAINE
Last Name:CARDOT
Suffix:
Gender:F
Credentials:MS, LPC, NCC
Other - Prefix:MISS
Other - First Name:TINA
Other - Middle Name:LORRAINE
Other - Last Name:WEIDLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LPC, NCC
Mailing Address - Street 1:3250 W LAKE RD
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16505-3691
Mailing Address - Country:US
Mailing Address - Phone:814-812-3671
Mailing Address - Fax:
Practice Address - Street 1:3250 W LAKE RD
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16505-3691
Practice Address - Country:US
Practice Address - Phone:814-812-3671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-08
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC003824101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
001751425OtherHIGHMARK KHPW