Healthcare Provider Details

I. General information

NPI: 1558439778
Provider Name (Legal Business Name): RAFAEL MICHAEL SCHOENBERG PSYCHOLOGIST
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 AKRON PENINSULA RD SUITE 101
AKRON OH
44313-5189
US

IV. Provider business mailing address

1660 AKRON-PENINSULA RD. SUITE 101
AKRON OH
44313-5193
US

V. Phone/Fax

Practice location:
  • Phone: 330-920-1660
  • Fax: 330-920-1373
Mailing address:
  • Phone: 330-920-1660
  • Fax: 330-920-1373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2467
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: