Provider Demographics
NPI:1902273691
Name:SCHOONOVER, CHELSEA ANNE (LISW, LCDC III)
Entity type:Individual
Prefix:MRS
First Name:CHELSEA
Middle Name:ANNE
Last Name:SCHOONOVER
Suffix:
Gender:F
Credentials:LISW, LCDC III
Other - Prefix:MRS
Other - First Name:CHELSEA
Other - Middle Name:ANNE
Other - Last Name:VILK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LISW, LCDC III
Mailing Address - Street 1:377 BEAUMONT DR
Mailing Address - Street 2:
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-3207
Mailing Address - Country:US
Mailing Address - Phone:440-231-2156
Mailing Address - Fax:
Practice Address - Street 1:9500 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-5925
Practice Address - Country:US
Practice Address - Phone:216-644-4949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-28
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1510169-TRNE1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2374229Medicaid