Individual provider Active NPI

Mychail B Scheramic, PSY.D., MBA

  • Clinical Neuropsychologist
  • Maumee, OH
National Provider Identifier
1376758565
Registry record updated Jul 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
4361 Issued in OH
Practice address
2340 Detroit Ave. at River Rd.
Maumee, OH 43537
Phone
(419) 277-7733
NPI assigned
May 11, 2007
Last updated
Jul 15, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 4361 OH Primary
Psychologist 103T00000X 4631 OH
Cognitive & Behavioral Psychologist 103TB0200X 4631 OH
Clinical Psychologist 103TC0700X 4631 OH
Family Psychologist 103TF0000X 4631 OH
Forensic Psychologist 103TF0200X 4631 OH
Health Psychologist 103TH0004X 4631 OH
Health Service Psychologist 103TH0100X 4631 OH
Rehabilitation Psychologist 103TR0400X 4631 OH
Marriage & Family Therapist 106H00000X 4631 OH

Addresses

Primary practice location

2340 Detroit Ave. at River Rd.
Maumee, OH 43537

Mailing address

330 Louisiana Ave
Ste a
Perrysburg, OH 43551-1470
Phone (419) 874-9488

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration

State licenses

LicenseStateTypeSpecialty
4631OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Resources for Healthy Living Inc Psychologist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468540800000",
    "number": "1376758565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 LOUISIANA AVE",
            "address_2": "STE A",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435511470",
            "telephone_number": "419-874-9488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2340 DETROIT AVE. AT RIVER RD.",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "43537",
            "telephone_number": "419-277-7733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHERAMIC",
        "first_name": "MYCHAIL",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "PSY.D., MBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-11",
        "last_updated": "2016-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "OH",
            "license": "4361",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "4631",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "OH",
            "license": "4631",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "4631",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "OH",
            "license": "4631",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "OH",
            "license": "4631",
            "primary": false
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "OH",
            "license": "4631",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "OH",
            "license": "4631",
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "OH",
            "license": "4631",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OH",
            "license": "4631",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maumee, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.