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General NPI Number Information
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NPI Number | 1457625030
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Entity Type | Individual
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Provider Name | ELIAS M KLEMPERER BA
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Gender | Male
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Dates
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Enumeration Date | 02/29/2012
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 111 COLCHESTER AVE
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City | BURLINGTON
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State | VT
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Zip | 05401-1473
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Country | US
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Telephone | 802-847-0000
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Fax |
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Provider Business Mailing Address
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Address Line | 3415 SE POWELL BLVD
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City | PORTLAND
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State | OR
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Zip | 97202-3371
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Country | US
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Telephone | 440-666-4867
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 048.0134378
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License Number State | VT
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