Provider Demographics
NPI:1528356219
Name:KLINE, PAULA MARIE (PHD, HSPP)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:MARIE
Last Name:KLINE
Suffix:
Gender:F
Credentials:PHD, HSPP
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:
Other - Last Name:EMKE-FRANCIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD, HSPP
Mailing Address - Street 1:606 WADE AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27605-1390
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:606 WADE AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27605-1390
Practice Address - Country:US
Practice Address - Phone:919-443-2360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-14
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X
IN20042643A103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201163160Medicaid
INM400069583Medicare PIN
IN201163160Medicaid