Healthcare Provider Details

I. General information

NPI: 1528930609
Provider Name (Legal Business Name): ASHLEIGH KLEIMAN
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/19/2025
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

721 W 13TH ST STE 121
JASPER IN
47546-1856
US

IV. Provider business mailing address

800 W 9TH ST
JASPER IN
47546-2514
US

V. Phone/Fax

Practice location:
  • Phone: 812-996-5780
  • Fax: 812-996-5784
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number33012713A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: