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General NPI Number Information
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NPI Number | 1316099591
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Entity Type | Individual
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Provider Name | STEPHANIE NICOLE KLEINBERG LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 19 WEST 34TH STREET PH
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City | NEW YORK CITY
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State | NY
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Zip | 10001
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Country | US
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Telephone | 212-726-3156
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Fax | 212-815-1268
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Provider Business Mailing Address
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Address Line | 67 71 YELLOWSTONE BLVD APT 6B
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City | FOREST HILLS
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State | NY
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Zip | 11375
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Country | US
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Telephone | 646-236-4774
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Fax | 212-815-1268
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | RO50060
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License Number State | NY
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