Provider Demographics
NPI:1194177162
Name:KLEEMAN, JAMIE (MFT)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:KLEEMAN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 SOUTH ST APT 2
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-4019
Mailing Address - Country:US
Mailing Address - Phone:720-314-8832
Mailing Address - Fax:
Practice Address - Street 1:611 LEOMINSTER RD
Practice Address - Street 2:
Practice Address - City:LUNENBURG
Practice Address - State:MA
Practice Address - Zip Code:01462
Practice Address - Country:US
Practice Address - Phone:978-582-7103
Practice Address - Fax:775-582-7103
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-01
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0001319106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist