Provider Demographics
NPI:1114343530
Name:KLEIN, REBECCA (LMFT)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:KLEIN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6811 SHAWNEE MISSION PKWY STE 310
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66202-4088
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6811 SHAWNEE MISSION PKWY STE 310
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66202-4088
Practice Address - Country:US
Practice Address - Phone:913-608-9940
Practice Address - Fax:913-229-7511
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-10
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
KS2546106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS201121660AMedicaid