Healthcare Provider Details

I. General information

NPI: 1154025161
Provider Name (Legal Business Name): TRISTEN IRENE KLEIN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2023
Last Update Date: 03/27/2023
Certification Date: 03/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 ECHO HL
DOBBS FERRY NY
10522-3600
US

IV. Provider business mailing address

1 ECHO HL
DOBBS FERRY NY
10522-3600
US

V. Phone/Fax

Practice location:
  • Phone: 914-693-0600
  • Fax:
Mailing address:
  • Phone: 914-693-0600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number102676
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: