Provider Demographics
NPI:1851533566
Name:VALLEY PSYCHOTHERAPY CENTER
Entity Type:Organization
Organization Name:VALLEY PSYCHOTHERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:SCHOENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:330-920-1660
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:44313-5189
Mailing Address - Country:US
Mailing Address - Phone:330-920-1660
Mailing Address - Fax:330-920-1373
Practice Address - Street 1:20545 CENTER RIDGE RD
Practice Address - Street 2:SUITE 116
Practice Address - City:ROCKY RIVER
Practice Address - State:OH
Practice Address - Zip Code:44116-3430
Practice Address - Country:US
Practice Address - Phone:440-333-6545
Practice Address - Fax:440-331-7710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-26
Last Update Date:2009-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHP2467101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0564652Medicaid
OHRASP03562Medicare PIN