Provider Demographics
NPI:1578509519
Name:KLEIN, BARBARA L (MS LICSW)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:L
Last Name:KLEIN
Suffix:
Gender:F
Credentials:MS LICSW
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:L
Other - Last Name:BETZLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1321 13TH ST N
Mailing Address - Street 2:
Mailing Address - City:ST CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-2614
Mailing Address - Country:US
Mailing Address - Phone:320-252-5010
Mailing Address - Fax:320-203-1855
Practice Address - Street 1:1321 13TH ST N
Practice Address - Street 2:
Practice Address - City:ST CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-2614
Practice Address - Country:US
Practice Address - Phone:320-252-5010
Practice Address - Fax:320-203-1855
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6177104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
6202387OtherMEDICA
922241022559OtherPREFERRED ONE
2H985KLOtherBCBS
HP26206OtherHEALTH PARTNERS