Healthcare Provider Details

I. General information

NPI: 1083670491
Provider Name (Legal Business Name): THOMAS MICHAEL KERN MS,CAC,LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 W 26TH ST SUITE 100
ERIE PA
16506-3254
US

IV. Provider business mailing address

215 W GORE RD
ERIE PA
16509-3625
US

V. Phone/Fax

Practice location:
  • Phone: 814-838-2282
  • Fax: 814-838-1091
Mailing address:
  • Phone: 814-838-2282
  • Fax: 814-838-1091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCAC NUMBER 0808
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC0001391
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: