Provider Demographics
NPI:1386705028
Name:KLEIN, SUEANNE (BA, QMHP)
Entity type:Individual
Prefix:
First Name:SUEANNE
Middle Name:
Last Name:KLEIN
Suffix:
Gender:F
Credentials:BA, QMHP
Other - Prefix:
Other - First Name:SUEANNE
Other - Middle Name:
Other - Last Name:KLEIN-PROCOPIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA,QMHP
Mailing Address - Street 1:8400 LOUISIANA ST
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-6385
Mailing Address - Country:US
Mailing Address - Phone:219-757-1932
Mailing Address - Fax:219-757-1950
Practice Address - Street 1:1409 E 84TH PL
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-6451
Practice Address - Country:US
Practice Address - Phone:219-794-2000
Practice Address - Fax:219-794-2010
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor