Healthcare Provider Details

I. General information

NPI: 1164552097
Provider Name (Legal Business Name): CLAUDIA A KLEIN MS LCP LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1969 W HART RD
BELOIT WI
53511
US

IV. Provider business mailing address

3925 WILSHIRE
JANESVILLE WI
53546
US

V. Phone/Fax

Practice location:
  • Phone: 608-364-5686
  • Fax: 608-363-5756
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number3189125
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: