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General NPI Number Information
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NPI Number | 1659291326
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Entity Type | Individual
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Provider Name | CHAD KLINE
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Gender | Male
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Dates
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Enumeration Date | 07/21/2026
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Last Update Date | 07/21/2026
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Provider Practice Location Address
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Address Line | 10200 W INNOVATION DR STE 800
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City | WAUWATOSA
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State | WI
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Zip | 53226-4827
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Country | US
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Telephone | 414-955-1040
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Fax |
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Provider Business Mailing Address
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Address Line | N58W24071 CLOVER DR APT 53
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City | SUSSEX
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State | WI
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Zip | 53089-5115
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Country | US
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Telephone | 443-794-7186
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 13042-123
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License Number State | WI
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