Provider Demographics
NPI:1528781663
Name:KLEIN, LAUREN ELIZABETH (CDCA)
Entity type:Individual
Prefix:MISS
First Name:LAUREN
Middle Name:ELIZABETH
Last Name:KLEIN
Suffix:
Gender:F
Credentials:CDCA
Other - Prefix:MRS
Other - First Name:LAUREN
Other - Middle Name:ELIZABETH
Other - Last Name:KLEIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:8621 CRITCHFIELD RD
Mailing Address - Street 2:
Mailing Address - City:SHREVE
Mailing Address - State:OH
Mailing Address - Zip Code:44676-9737
Mailing Address - Country:US
Mailing Address - Phone:330-231-5971
Mailing Address - Fax:
Practice Address - Street 1:2177 NOBLE DR
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-5351
Practice Address - Country:US
Practice Address - Phone:330-264-8498
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-23
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA.182043101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)