Provider Demographics
NPI:1558590646
Name:SCHATZER, THOMAS ALLEN (LICDC)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:ALLEN
Last Name:SCHATZER
Suffix:
Gender:M
Credentials:LICDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 PRO DR
Mailing Address - Street 2:
Mailing Address - City:CELINA
Mailing Address - State:OH
Mailing Address - Zip Code:45822-1360
Mailing Address - Country:US
Mailing Address - Phone:419-586-4030
Mailing Address - Fax:419-586-3268
Practice Address - Street 1:800 PRO DR
Practice Address - Street 2:
Practice Address - City:CELINA
Practice Address - State:OH
Practice Address - Zip Code:45822-1360
Practice Address - Country:US
Practice Address - Phone:419-586-4030
Practice Address - Fax:419-586-3268
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-09
Last Update Date:2009-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH943926101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)