Provider Demographics
NPI:1962292219
Name:THERESA TSCHANNEN, PHD LLC
Entity type:Organization
Organization Name:THERESA TSCHANNEN, PHD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:TSCHANNEN ISABELLA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:330-421-7805
Mailing Address - Street 1:5054 PARAMOUNT DR OFC 9
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-5363
Mailing Address - Country:US
Mailing Address - Phone:330-304-8290
Mailing Address - Fax:
Practice Address - Street 1:5054 PARAMOUNT DR OFC 9
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-5363
Practice Address - Country:US
Practice Address - Phone:330-304-8290
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-09
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty