Provider Demographics
NPI:1386288850
Name:KLAU-STEVENS, MICHAL B
Entity type:Individual
Prefix:
First Name:MICHAL
Middle Name:B
Last Name:KLAU-STEVENS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 WATERSIDE XING STE 401
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06095-1587
Mailing Address - Country:US
Mailing Address - Phone:860-731-5522
Mailing Address - Fax:
Practice Address - Street 1:999 ASYLUM AVE STE 502
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06105-2475
Practice Address - Country:US
Practice Address - Phone:860-731-5522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-29
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker