Provider Demographics
NPI:1558496216
Name:KLEIN, ANDREW BARTLEY (MS LCA-DC)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:BARTLEY
Last Name:KLEIN
Suffix:
Gender:M
Credentials:MS LCA-DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11921 TARRAGON RD
Mailing Address - Street 2:
Mailing Address - City:REISTERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21136-3181
Mailing Address - Country:US
Mailing Address - Phone:443-394-0358
Mailing Address - Fax:
Practice Address - Street 1:10151 YORK RD STE 102
Practice Address - Street 2:
Practice Address - City:COCKEYSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21030-3314
Practice Address - Country:US
Practice Address - Phone:410-887-7671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCA266101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)