MEDICARE: MR. LEONARDO JAVIER KLEIN LCSW

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

General Provider Information

NPI Number	:	1952473225
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. LEONARDO JAVIER KLEIN LCSW

Provider Business Mailing Address
First Line	:	2234 77TH ST
Second Line	:	APT B1
City	:	EAST ELMHURST
State	:	NY
Zip	:	11370-1232
Country	:	US
Telephone Number	:	718-267-1668
Fax Number	:

Provider Business Practice Location Address
First Line	:	8211 37TH AVE
Second Line	:	401
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-7001
Country	:	US
Telephone Number	:	718-396-6766
Fax Number	:	718-396-6645

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

Provider Enumeration Date	:	11/14/2006
Last Update Date	:	01/12/2015

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