Healthcare Provider Details

I. General information

NPI: 1609510890
Provider Name (Legal Business Name): KATIE SCHMUCKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2022
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6101 WHIPPLE AVE NW
NORTH CANTON OH
44720-7617
US

IV. Provider business mailing address

6101 WHIPPLE AVE NW
NORTH CANTON OH
44720-7617
US

V. Phone/Fax

Practice location:
  • Phone: 330-537-8114
  • Fax:
Mailing address:
  • Phone: 330-537-8114
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number180216
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.2208293
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: