Provider Demographics
NPI:1447871637
Name:KLEIN, JAMES DOUGLAS (LMSW)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:DOUGLAS
Last Name:KLEIN
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 MOONLIGHT DR
Mailing Address - Street 2:
Mailing Address - City:PLATTEVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53818-1927
Mailing Address - Country:US
Mailing Address - Phone:715-252-7059
Mailing Address - Fax:
Practice Address - Street 1:205 MOONLIGHT DR
Practice Address - Street 2:
Practice Address - City:PLATTEVILLE
Practice Address - State:WI
Practice Address - Zip Code:53818-1927
Practice Address - Country:US
Practice Address - Phone:715-252-7059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-29
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker