Provider Demographics
NPI:1508107491
Name:STEVEN KLEIN, PH.D., S.C.
Entity Type:Organization
Organization Name:STEVEN KLEIN, PH.D., S.C.
Other - Org Name:STEVEN KLEIN, PH.D., S.C.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:P
Authorized Official - Last Name:KLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:920-749-1005
Mailing Address - Street 1:5733 W GRANDE MARKET DR
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54913-8472
Mailing Address - Country:US
Mailing Address - Phone:920-749-1005
Mailing Address - Fax:920-749-4914
Practice Address - Street 1:5733 W GRANDE MARKET DR
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54913-8472
Practice Address - Country:US
Practice Address - Phone:920-749-1005
Practice Address - Fax:920-749-4914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-03
Last Update Date:2015-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1262103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty