Provider Demographics
NPI:1790701233
Name:SCHAFER, PATRICIA A (PCC-S, LICDC)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:A
Last Name:SCHAFER
Suffix:
Gender:F
Credentials:PCC-S, LICDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32300 TRACY LN
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-2010
Mailing Address - Country:US
Mailing Address - Phone:440-349-4521
Mailing Address - Fax:440-349-4521
Practice Address - Street 1:29525 CHAGRIN BLVD
Practice Address - Street 2:202
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-4644
Practice Address - Country:US
Practice Address - Phone:440-349-4521
Practice Address - Fax:440-349-4521
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-15
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH011111101YA0400X
OHE4294101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)