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General NPI Number Information
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NPI Number | 1922372069
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Entity Type | Individual
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Provider Name | ELIZABETH KLEIN LMFT
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Gender | Female
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Dates
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Enumeration Date | 03/07/2012
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Last Update Date | 07/20/2019
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Provider Practice Location Address
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Address Line | 1599 SELBY AVE STE 105LL
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City | SAINT PAUL
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State | MN
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Zip | 55104
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Country | US
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Telephone | 612-470-0991
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Fax | 833-391-3575
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Provider Business Mailing Address
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Address Line | 1599 SELBY AVE STE 105LL
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City | SAINT PAUL
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State | MN
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Zip | 55104-6375
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Country | US
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Telephone | 612-470-0991
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Fax | 833-391-3575
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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 | 4889
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 1160
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 3661
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License Number State | MN
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