Provider Demographics
NPI:1457985434
Name:TOME, MICHELE ANN (LPC)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:ANN
Last Name:TOME
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9751 EDINBORO RD
Mailing Address - Street 2:
Mailing Address - City:MC KEAN
Mailing Address - State:PA
Mailing Address - Zip Code:16426-1915
Mailing Address - Country:US
Mailing Address - Phone:814-450-6106
Mailing Address - Fax:
Practice Address - Street 1:435 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-4404
Practice Address - Country:US
Practice Address - Phone:814-807-0861
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-27
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC009815101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional