=====================================================
General NPI Number Information
=====================================================
NPI Number | 1033514237
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SONYA KLEIN LCSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/30/2014
-----------------------------------------------------
Last Update Date | 06/27/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 94 EAST AVE
-----------------------------------------------------
City | NORWALK
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06851-5024
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-512-4517
-----------------------------------------------------
Fax | 203-202-9421
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 16 MORLEY LN
-----------------------------------------------------
City | DARIEN
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06820-6018
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-512-4517
-----------------------------------------------------
Fax | 203-202-9421
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------