Provider Demographics
NPI:1710458641
Name:CERNAVA-SCHNEIDER, PATRICIA (LISW-S, LICDC-CS)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:CERNAVA-SCHNEIDER
Suffix:
Gender:F
Credentials:LISW-S, LICDC-CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2271
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:44601-0271
Mailing Address - Country:US
Mailing Address - Phone:330-309-8313
Mailing Address - Fax:
Practice Address - Street 1:526 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601-2429
Practice Address - Country:US
Practice Address - Phone:330-309-8313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH071044101YA0400X
OHI10001741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)