Provider Demographics
NPI:1083154439
Name:JUDITH KLEBER
Entity Type:Organization
Organization Name:JUDITH KLEBER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:KLEBER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:212-721-7221
Mailing Address - Street 1:304 W 75TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-1689
Mailing Address - Country:US
Mailing Address - Phone:212-721-7221
Mailing Address - Fax:
Practice Address - Street 1:304 W 75TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-1689
Practice Address - Country:US
Practice Address - Phone:212-721-7221
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-05
Last Update Date:2017-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY076349-1261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health