Provider Demographics
NPI:1306599907
Name:KLEIN, ANGELA MADELYN (LMHCA)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:MADELYN
Last Name:KLEIN
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 S ARTHUR ST STE 665
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-2212
Mailing Address - Country:US
Mailing Address - Phone:816-516-2252
Mailing Address - Fax:
Practice Address - Street 1:140 S ARTHUR ST STE 665
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-2212
Practice Address - Country:US
Practice Address - Phone:816-516-2252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-02
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61231396101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA61231396OtherLMHCA LICENSE NUMBER