Healthcare Provider Details

I. General information

NPI: 1841507720
Provider Name (Legal Business Name): JONATHAN L. KLEINMAN LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/13/2010
Last Update Date: 12/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

369 ASHFORD AVE
DOBBS FERRY NY
10522-2626
US

IV. Provider business mailing address

369 ASHFORD AVE SUITE N
DOBBS FERRY NY
10522-2626
US

V. Phone/Fax

Practice location:
  • Phone: 917-923-6185
  • Fax:
Mailing address:
  • Phone: 917-923-6185
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number072759-1
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: