Provider Demographics
NPI:1427221225
Name:MICHAEL B. SCHACHERE, PHD, INC.
Entity Type:Organization
Organization Name:MICHAEL B. SCHACHERE, PHD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:WEISS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-831-2226
Mailing Address - Street 1:24100 CHAGRIN BLVD
Mailing Address - Street 2:SUITE 370
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5535
Mailing Address - Country:US
Mailing Address - Phone:216-831-2226
Mailing Address - Fax:216-831-2351
Practice Address - Street 1:24100 CHAGRIN BLVD
Practice Address - Street 2:SUITE 370
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5535
Practice Address - Country:US
Practice Address - Phone:216-831-2226
Practice Address - Fax:216-831-2351
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-12
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4177103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
00000066218OtherANTHEM BLUE CROSS/BLUE SH
=========003OtherMEDICAL MUTUAL
OH9344121Medicare PIN