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NPI Code Detail

MEDICARE: DR. PATRICIA A. SCHAFER PCC-S, LICDC

MEDICARE:  DR. PATRICIA A. SCHAFER  PCC-S, LICDC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor011111OH
2101YP2500XProfessional CounselorE4294OH

General Provider Information

NPI Number : 1790701233
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PATRICIA A. SCHAFER PCC-S, LICDC
Provider Business Mailing Address
First Line : 32300 TRACY LN
Second Line :
City : SOLON
State : OH
Zip : 44139-2010
Country : US
Telephone Number : 440-349-4521
Fax Number : 440-349-4521
Provider Business Practice Location Address
First Line : 29525 CHAGRIN BLVD
Second Line : 202
City : BEACHWOOD
State : OH
Zip : 44122-4644
Country : US
Telephone Number : 440-349-4521
Fax Number : 440-349-4521
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2006
Last Update Date : 04/07/2010

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Directions to “ DR. PATRICIA A. SCHAFER PCC-S, LICDC” Practice Location

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