Provider Demographics
NPI:1861944803
Name:CATHERINE KLEIN
Entity type:Organization
Organization Name:CATHERINE KLEIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:KLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW/C
Authorized Official - Phone:443-613-3823
Mailing Address - Street 1:120 W SEMINARY AVE
Mailing Address - Street 2:
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-5523
Mailing Address - Country:US
Mailing Address - Phone:410-613-3823
Mailing Address - Fax:410-630-1647
Practice Address - Street 1:120 W SEMINARY AVE
Practice Address - Street 2:
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-5523
Practice Address - Country:US
Practice Address - Phone:410-613-3823
Practice Address - Fax:410-630-1647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-25
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD10607101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD503739Medicare PIN