Provider Demographics
NPI:1447360011
Name:KLEINMAN, SETH DAVID (LICSW)
Entity type:Individual
Prefix:MR
First Name:SETH
Middle Name:DAVID
Last Name:KLEINMAN
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 ATHERTON ST
Mailing Address - Street 2:#2
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02143-2604
Mailing Address - Country:US
Mailing Address - Phone:978-688-8004
Mailing Address - Fax:978-686-8554
Practice Address - Street 1:873 TURNPIKE ST
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-6152
Practice Address - Country:US
Practice Address - Phone:978-688-8004
Practice Address - Fax:978-686-8554
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA111767104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker