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General NPI Number Information
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NPI Number | 1407059454
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Entity Type | Individual
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Provider Name | DENEAN RENEE KLINE NCC, LPC, LCDC, SAP
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Gender | Female
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Dates
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Enumeration Date | 06/07/2007
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Last Update Date | 02/05/2019
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Provider Practice Location Address
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Address Line | 1848 LONE STAR RD STE 109
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City | MANSFIELD
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State | TX
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Zip | 76063
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Country | US
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Telephone | 817-239-5488
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Fax |
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Provider Business Mailing Address
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Address Line | 1848 LONE STAR RD STE 109
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City | MANSFIELD
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State | TX
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Zip | 76063-5785
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Country | US
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Telephone | 817-239-5488
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Fax |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 3429
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 63034
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 10370
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License Number State | TX
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