Healthcare Provider Details

I. General information

NPI: 1568411783
Provider Name (Legal Business Name): JEFFREY WILLIAM KLEIN LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2006
Last Update Date: 06/15/2022
Certification Date: 06/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3008 DAWN DR STE 101
GEORGETOWN TX
78628-2822
US

IV. Provider business mailing address

PO BOX 2926
GEORGETOWN TX
78627-2926
US

V. Phone/Fax

Practice location:
  • Phone: 512-451-7337
  • Fax: 512-451-8729
Mailing address:
  • Phone: 512-864-5875
  • Fax: 512-451-8729

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: