Provider Demographics
NPI:1558053090
Name:POTVIN, NOAH (LPC, MT-BC)
Entity Type:Individual
Prefix:DR
First Name:NOAH
Middle Name:
Last Name:POTVIN
Suffix:
Gender:M
Credentials:LPC, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:489 LONGRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15243-2049
Mailing Address - Country:US
Mailing Address - Phone:215-680-2683
Mailing Address - Fax:
Practice Address - Street 1:489 LONGRIDGE DR
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15243-2049
Practice Address - Country:US
Practice Address - Phone:215-680-2683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-23
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA850730101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty