Provider Demographics
NPI:1447437983
Name:BETH KLEIN PHD LLC
Entity type:Organization
Organization Name:BETH KLEIN PHD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:KLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:954-423-4231
Mailing Address - Street 1:20421 SW 51ST ST
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33332-1565
Mailing Address - Country:US
Mailing Address - Phone:954-423-4231
Mailing Address - Fax:
Practice Address - Street 1:1625 N COMMERCE PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-3216
Practice Address - Country:US
Practice Address - Phone:954-423-4231
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-28
Last Update Date:2014-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY5943103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLBK54459OtherBCBS
FLBK54459OtherBCBS
FLAK078Medicare PIN