Provider Demographics
NPI:1891748976
Name:KLEIN, MARSHA (LMHC)
Entity type:Individual
Prefix:
First Name:MARSHA
Middle Name:
Last Name:KLEIN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 WORCESTER ST
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02481-5506
Mailing Address - Country:US
Mailing Address - Phone:781-431-1333
Mailing Address - Fax:781-431-1933
Practice Address - Street 1:170 WORCESTER ST
Practice Address - Street 2:
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02481-5506
Practice Address - Country:US
Practice Address - Phone:781-431-1333
Practice Address - Fax:781-431-1933
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2013-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMHC00179101Y00000X
MA7892101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIMK26858Medicaid
MA7892Medicaid