Healthcare Provider Details

I. General information

NPI: 1790452274
Provider Name (Legal Business Name): STEVEN MICHAEL SCHROECK LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2021
Last Update Date: 08/24/2021
Certification Date: 08/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3645 RIDGE MILL DR # 7752
HILLIARD OH
43026-7752
US

IV. Provider business mailing address

3645 RIDGE MILL DR # 7752
HILLIARD OH
43026-7752
US

V. Phone/Fax

Practice location:
  • Phone: 614-457-7876
  • Fax:
Mailing address:
  • Phone: 614-457-7876
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC.2103627
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: