Provider Demographics
NPI:1376758565
Name:SCHERAMIC, MYCHAIL B (PSYD, MBA)
Entity Type:Individual
Prefix:DR
First Name:MYCHAIL
Middle Name:B
Last Name:SCHERAMIC
Suffix:
Gender:M
Credentials:PSYD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 LOUISIANA AVE
Mailing Address - Street 2:STE A
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-1470
Mailing Address - Country:US
Mailing Address - Phone:419-874-9488
Mailing Address - Fax:
Practice Address - Street 1:2340 DETROIT AVE. AT RIVER RD.
Practice Address - Street 2:
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537
Practice Address - Country:US
Practice Address - Phone:419-277-7733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4361103G00000X
OH4631103T00000X, 103TB0200X, 103TC0700X, 103TF0000X, 103TF0200X, 103TH0004X, 103TH0100X, 103TR0400X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist