1528080918 NPI number — ESTHER L KLEIN LCSW

Table of content: ESTHER L KLEIN LCSW (NPI 1528080918)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528080918 NPI number — ESTHER L KLEIN LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KLEIN
Provider First Name:
ESTHER
Provider Middle Name:
L
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528080918
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1706 CYPRESS TRACE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAFETY HARBOR
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34695-4501
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
727-726-5049
Provider Business Mailing Address Fax Number:
866-469-3880

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
132 10TH AVENUE NORTH
Provider Second Line Business Practice Location Address:
SUITE 103
Provider Business Practice Location Address City Name:
CLEARWATER
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33761-2631
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-726-5049
Provider Business Practice Location Address Fax Number:
866-469-3880
Provider Enumeration Date:
07/24/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  SW782 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: Z2437 . This is a "BLUE SHIELD OF FLORIDA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 162533100 . This is a "US DEPARTMENT OF LABOR" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 7735105 . This is a "AETNA BEHAVIORAL HEALTH" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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