=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447190863
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BENJAMIN PAUL SCHADE LSP
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/30/2026
-----------------------------------------------------
Last Update Date | 03/30/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9826 WASHINGTON ST
-----------------------------------------------------
City | CHAGRIN FALLS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44023-5401
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 440-708-0188
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2595 TOWNLINE RD
-----------------------------------------------------
City | MADISON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44057-2342
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-979-4045
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TS0200X
-----------------------------------------------------
Taxonomy Name | School Psychologist
-----------------------------------------------------
License Number | SP.00761
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------