Healthcare Provider Details

I. General information

NPI: 1598606543
Provider Name (Legal Business Name): COOPER JOSEPH SCHMIDT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2026
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 ABBE RD S
ELYRIA OH
44035-7246
US

IV. Provider business mailing address

750 ABBE RD S
ELYRIA OH
44035-7246
US

V. Phone/Fax

Practice location:
  • Phone: 440-323-5121
  • Fax:
Mailing address:
  • Phone: 440-323-5121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDCA.194788
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: