Provider Demographics
NPI:1518064492
Name:CLEIN, REUVEN ABRAHAM (LPC)
Entity Type:Individual
Prefix:MR
First Name:REUVEN
Middle Name:ABRAHAM
Last Name:CLEIN
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 1:112 ROPE FERRY RD
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06385-2620
Mailing Address - Country:US
Mailing Address - Phone:860-437-7567
Mailing Address - Fax:
Practice Address - Street 1:567 VAUXHALL STREET EXT
Practice Address - Street 2:SUITE 323
Practice Address - City:WATERFORD
Practice Address - State:CT
Practice Address - Zip Code:06385-4330
Practice Address - Country:US
Practice Address - Phone:860-447-9274
Practice Address - Fax:860-447-9900
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001532101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health