Provider Demographics
NPI:1558439778
Name:SCHOENBERG, RAFAEL MICHAEL (PSYCHOLOGIST)
Entity Type:Individual
Prefix:
First Name:RAFAEL
Middle Name:MICHAEL
Last Name:SCHOENBERG
Suffix:
Gender:M
Credentials:PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1660 AKRON-PENINSULA RD.
Mailing Address - Street 2:SUITE 101
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-5193
Mailing Address - Country:US
Mailing Address - Phone:330-920-1660
Mailing Address - Fax:330-920-1373
Practice Address - Street 1:1660 AKRON PENINSULA RD
Practice Address - Street 2:SUITE 101
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313-5189
Practice Address - Country:US
Practice Address - Phone:330-920-1660
Practice Address - Fax:330-920-1373
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2467101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH34169555000OtherBCBS PROVIDER NUMBER
OH136901OtherANTHEMBLUECROSS
OHRASP03561Medicare ID - Type UnspecifiedMEDICARE