Provider Demographics
NPI:1295360162
Name:KLEIN, VICKI (MSW, LCSW-C)
Entity Type:Individual
Prefix:
First Name:VICKI
Middle Name:
Last Name:KLEIN
Suffix:
Gender:F
Credentials:MSW, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8928 COLD SPRING RD
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-2345
Mailing Address - Country:US
Mailing Address - Phone:301-775-6931
Mailing Address - Fax:
Practice Address - Street 1:11300 ROCKVILLE PIKE STE 503
Practice Address - Street 2:
Practice Address - City:NORTH BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20852-3070
Practice Address - Country:US
Practice Address - Phone:301-775-6931
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-11
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD105901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical