Healthcare Provider Details

I. General information

NPI: 1205024239
Provider Name (Legal Business Name): MICHAEL C KLEIN MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2007
Last Update Date: 10/03/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

63 HARMONY HILL RD C/O HARMONY HILL SCHOOL
CHEPACHET RI
02814-1429
US

IV. Provider business mailing address

63 HARMONY HILL RD C/O HARMONY HILL SCHOOL
CHEPACHET RI
02814-1429
US

V. Phone/Fax

Practice location:
  • Phone: 401-949-0690
  • Fax: 401-949-2060
Mailing address:
  • Phone: 401-949-0690
  • Fax: 401-949-2060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberISW00446
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: