MEDICARE: ADAM ALBERT KLEINMAN L.C.S.W.

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	1041C0700X	Clinical Social Worker	CW017759	PA

General Provider Information

NPI Number	:	1942556949
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADAM ALBERT KLEINMAN L.C.S.W.

Provider Business Mailing Address
First Line	:	2517 BEDFORD ST
Second Line	:
City	:	JOHNSTOWN
State	:	PA
Zip	:	15904-1424
Country	:	US
Telephone Number	:	814-241-7990
Fax Number	:	814-217-1327

Provider Business Practice Location Address
First Line	:	2517 BEDFORD ST
Second Line	:
City	:	JOHNSTOWN
State	:	PA
Zip	:	15904-1424
Country	:	US
Telephone Number	:	814-241-7990
Fax Number	:	814-217-1327

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

Provider Enumeration Date	:	07/27/2012
Last Update Date	:	06/10/2019

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