MEDICARE: MRS. KARA COLLEEN KLEIN MA ED, PCC

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	101YM0800X	Mental Health Counselor	E-0600006	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	12256521	OTHER		CAQH

General Provider Information

NPI Number	:	1225184898
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KARA COLLEEN KLEIN MA ED, PCC

Provider Business Mailing Address
First Line	:	3618 W MARKET ST STE 7
Second Line	:
City	:	FAIRLAWN
State	:	OH
Zip	:	44333-2425
Country	:	US
Telephone Number	:	234-281-2895
Fax Number	:

Provider Business Practice Location Address
First Line	:	3618 W MARKET ST STE 7
Second Line	:
City	:	FAIRLAWN
State	:	OH
Zip	:	44333-2425
Country	:	US
Telephone Number	:	234-281-2895
Fax Number	:

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

Provider Enumeration Date	:	01/26/2007
Last Update Date	:	03/08/2022

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