Provider Demographics
NPI:1083121552
Name:KLEIN, PAULINE (MSW)
Entity Type:Individual
Prefix:
First Name:PAULINE
Middle Name:
Last Name:KLEIN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2104 HUIDEKOPER PL NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007-1822
Mailing Address - Country:US
Mailing Address - Phone:202-333-7146
Mailing Address - Fax:
Practice Address - Street 1:908 NEW HAMPSHIRE AVE NW STE 303
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-2350
Practice Address - Country:US
Practice Address - Phone:202-463-0650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-05
Last Update Date:2018-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC3005921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty