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General NPI Number Information
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NPI Number | 1932571445
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Entity Type | Organization
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Legal Business Name | KLEIN MORAN MENTAL HEALTH COUNSELING, PLLC
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Dates
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Enumeration Date | 10/22/2015
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Last Update Date | 10/22/2015
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Provider Practice Location Address
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Address Line | 1050 HALLOCK AVE
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City | PORT JEFFERSON STATION
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State | NY
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Zip | 11776-1214
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Country | US
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Telephone | 631-686-8057
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Fax | 530-706-6107
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Provider Business Mailing Address
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Address Line | 1 ARROWOOD DR
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City | SAINT JAMES
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State | NY
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Zip | 11780-3412
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Country | US
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Telephone | 631-686-8057
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Fax | 530-706-6107
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Authorized Official
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Title or Position | MENTAL HEALTH COUNSELOR
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Name | MRS. MORAN KLEIN
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Credential |
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Telephone | 631-686-8057
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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 | 006346-1
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License Number State | NY
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