Provider Demographics
NPI:1407877939
Name:KLEIN, PATRICK RALPH (LCSW)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:RALPH
Last Name:KLEIN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6127 OAK RIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34653-4234
Mailing Address - Country:US
Mailing Address - Phone:727-841-8973
Mailing Address - Fax:727-816-9745
Practice Address - Street 1:2708 ALT 19
Practice Address - Street 2:SUITE 507-10
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34683-2665
Practice Address - Country:US
Practice Address - Phone:727-787-6177
Practice Address - Fax:727-787-8406
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW49951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL210637OtherCOMPSYCH
FL7674353OtherAETNA
FLFL1888OtherBRADMAN
FLZ8321OtherHUMANA
FLZ8321OtherMENTAL HEALTH NETWORK
FL348932000OtherMAGELLAN
FLZ8321OtherBLUECROSS/BLUESHIELD HEAL
FLZ8321OtherMENTAL HEALTH NETWORK
FLZ8321Medicare ID - Type UnspecifiedFIRST COAST SERVICE OPTIO
FL348932000OtherMAGELLAN