Provider Demographics
NPI:1508067562
Name:KLINE, THOMAS PEYTON (LPC)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:PEYTON
Last Name:KLINE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 FIRST STREET
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:OR
Mailing Address - Zip Code:97452
Mailing Address - Country:US
Mailing Address - Phone:541-517-6138
Mailing Address - Fax:541-942-9849
Practice Address - Street 1:401 E. 10TH AVENUE
Practice Address - Street 2:SUITE 200
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401
Practice Address - Country:US
Practice Address - Phone:541-517-6138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1649101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional