Healthcare Provider Details

I. General information

NPI: 1326694332
Provider Name (Legal Business Name): SCOTT EDWARD KLEINERT LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2019
Last Update Date: 04/02/2020
Certification Date: 04/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 SANGERS LN
STAUNTON VA
24401-6712
US

IV. Provider business mailing address

25 NORTHRIDGE LN
LEXINGTON VA
24450-3399
US

V. Phone/Fax

Practice location:
  • Phone: 540-887-3200
  • Fax:
Mailing address:
  • Phone: 540-464-8700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701008561
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: