MEDICARE: MS. MICHELINE MARIE O'HAIRE KLEIN LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	CSW009767	GA

General Provider Information

NPI Number	:	1699917641
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MICHELINE MARIE O'HAIRE KLEIN LCSW

Provider Business Mailing Address
First Line	:	982 STOVER RD
Second Line	:
City	:	CANTON
State	:	GA
Zip	:	30115-4513
Country	:	US
Telephone Number	:	516-901-2545
Fax Number	:

Provider Business Practice Location Address
First Line	:	982 STOVER RD
Second Line	:
City	:	CANTON
State	:	GA
Zip	:	30115-4513
Country	:	US
Telephone Number	:	770-647-1260
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2009
Last Update Date	:	01/07/2026

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