Provider Demographics
NPI:1689051930
Name:PERDIAN, THOMAS (MA, NCC, LPC)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:
Last Name:PERDIAN
Suffix:
Gender:M
Credentials:MA, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 HUNTER RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-8031
Mailing Address - Country:US
Mailing Address - Phone:724-977-5869
Mailing Address - Fax:888-237-6960
Practice Address - Street 1:115 HUNTER RIDGE RD
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-8031
Practice Address - Country:US
Practice Address - Phone:724-977-5869
Practice Address - Fax:888-237-6960
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-06
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC007088101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional