Provider Demographics
NPI:1376637934
Name:KLEINMAN, LAURA J (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:J
Last Name:KLEINMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 FULTON ST
Mailing Address - Street 2:APT 25N
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038-1864
Mailing Address - Country:US
Mailing Address - Phone:917-617-0055
Mailing Address - Fax:
Practice Address - Street 1:77 FULTON ST
Practice Address - Street 2:APT 25N
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-1864
Practice Address - Country:US
Practice Address - Phone:917-617-0055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2011-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0771301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical