=====================================================
General NPI Number Information
=====================================================
NPI Number | 1033383179
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ESTHER L KLEIN, PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/19/2008
-----------------------------------------------------
Last Update Date | 07/16/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 132 10TH AVE N SUITE 103
-----------------------------------------------------
City | SAFETY HARBOR
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34695-3407
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-726-5049
-----------------------------------------------------
Fax | 866-469-3880
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1706 CYPRESS TRACE DR
-----------------------------------------------------
City | SAFETY HARBOR
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34695-4501
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-726-5049
-----------------------------------------------------
Fax | 866-469-3880
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MS. ESTHER L KLEIN
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 727-726-5049
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | SW0782
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------