Provider Demographics
NPI:1225184898
Name:KLEIN, KARA COLLEEN (MA ED, PCC)
Entity type:Individual
Prefix:MRS
First Name:KARA
Middle Name:COLLEEN
Last Name:KLEIN
Suffix:
Gender:F
Credentials:MA ED, PCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3618 W MARKET ST STE 7
Mailing Address - Street 2:
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-2425
Mailing Address - Country:US
Mailing Address - Phone:234-281-2895
Mailing Address - Fax:
Practice Address - Street 1:3618 W MARKET ST STE 7
Practice Address - Street 2:
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-2425
Practice Address - Country:US
Practice Address - Phone:234-281-2895
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE-0600006101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
12256521OtherCAQH