Basic Information
| Provider Information | |||||||||
| NPI: | 1538120217 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NOWAK | ||||||||
| FirstName: | THOMAS | ||||||||
| MiddleName: | JOHN | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | LPC NCC CCDPD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 27 COLECREST ST | ||||||||
| Address2: | |||||||||
| City: | CARNEGIE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 151061733 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4122008171 | ||||||||
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| Practice Location | |||||||||
| Address1: | 801 UNION AVE | ||||||||
| Address2: | CHRISTIAN COUNSELORS COOPERATIVE, 5TH FLOOR | ||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 15212 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4125863684 | ||||||||
| FaxNumber: | 4126611304 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/31/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | PC000532 | PA | X | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 101YP1600X | PC000532 | PA | X | Behavioral Health & Social Service Providers | Counselor | Pastoral | 101YP2500X | LPC PC000532 | PA | X | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.