MEDICARE: ALICIA KLEIN CADC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	24047	IA

General Provider Information

NPI Number	:	1114806361
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALICIA KLEIN CADC

Provider Business Mailing Address
First Line	:	815 LEXINGTON ST
Second Line	:
City	:	CARLISLE
State	:	IA
Zip	:	50047-7797
Country	:	US
Telephone Number	:	515-554-9665
Fax Number	:

Provider Business Practice Location Address
First Line	:	501 N SHERMAN ST
Second Line	:
City	:	PRAIRIE CITY
State	:	IA
Zip	:	50228-8666
Country	:	US
Telephone Number	:	515-994-3562
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/01/2025
Last Update Date	:	09/01/2025

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