Individual provider Active NPI

Patricia A. Schafer, PCC-S, LICDC

  • Professional Counselor
  • Beachwood, OH
National Provider Identifier
1790701233
Registry record updated Apr 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E4294 Issued in OH
Practice address
29525 Chagrin Blvd
202
Beachwood, OH 44122-4644
Phone
(440) 349-4521
Fax
(440) 349-4521
NPI assigned
Jul 15, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 011111 OH
Professional Counselor 101YP2500X E4294 OH Primary

Addresses

Primary practice location

29525 Chagrin Blvd
202
Beachwood, OH 44122-4644

Mailing address

32300 Tracy LN
Solon, OH 44139-2010
Phone (440) 349-4521

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
011111OHMDAddiction (Substance Use Disorder) Counselor
E4294OHMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270598400000",
    "number": "1790701233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32300 TRACY LN",
            "city": "SOLON",
            "state": "OH",
            "postal_code": "441392010",
            "telephone_number": "440-349-4521",
            "fax_number": "440-349-4521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29525 CHAGRIN BLVD",
            "address_2": "202",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441224644",
            "telephone_number": "440-349-4521",
            "fax_number": "440-349-4521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAFER",
        "first_name": "PATRICIA",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "PCC-S, LICDC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-15",
        "last_updated": "2010-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "011111",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E4294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beachwood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2010; 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.