Provider Demographics
NPI:1164187688
Name:ALAN JAMES KLEIN, PH.D., A PROFESSIONAL PSYCHOLOGY CORPORATION
Entity Type:Organization
Organization Name:ALAN JAMES KLEIN, PH.D., A PROFESSIONAL PSYCHOLOGY CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:KLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:198-523-7250
Mailing Address - Street 1:PO BOX 1615
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70470-1615
Mailing Address - Country:US
Mailing Address - Phone:985-893-6860
Mailing Address - Fax:
Practice Address - Street 1:5001 HIGHWAY 190 EAST SERVICE RD STE D1
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-4956
Practice Address - Country:US
Practice Address - Phone:985-893-6860
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-01
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty