Provider Demographics
NPI:1598820060
Name:SCHAACK, RONNI L (LPCC)
Entity Type:Individual
Prefix:MRS
First Name:RONNI
Middle Name:L
Last Name:SCHAACK
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1469 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-4245
Mailing Address - Country:US
Mailing Address - Phone:330-499-3065
Mailing Address - Fax:
Practice Address - Street 1:1469 S MAIN ST
Practice Address - Street 2:GENTLE SHEPHERD COUNSELING CENTER
Practice Address - City:N CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720
Practice Address - Country:US
Practice Address - Phone:330-499-3065
Practice Address - Fax:330-499-2497
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH#E0004368101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000495557OtherANTHEM BL CROSS
OH282988926004OtherMEDICAL MUTUAL OF OH