Provider Demographics
NPI:1629258199
Name:KOLOC, THOMAS STEPHEN (LPC, NCC, CEAP)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:STEPHEN
Last Name:KOLOC
Suffix:
Gender:M
Credentials:LPC, NCC, CEAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1382 OLD FREEPORT RD
Mailing Address - Street 2:SUITE 2AF
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15238-3159
Mailing Address - Country:US
Mailing Address - Phone:412-963-7956
Mailing Address - Fax:
Practice Address - Street 1:1382 OLD FREEPORT RD
Practice Address - Street 2:SUITE 2AF
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15238-3159
Practice Address - Country:US
Practice Address - Phone:412-963-7956
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-13
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC001109101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional