Provider Demographics
NPI:1568631679
Name:CLINE, JAMES D (MA,LMHC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:D
Last Name:CLINE
Suffix:
Gender:M
Credentials:MA,LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2698 N 1100 W
Mailing Address - Street 2:
Mailing Address - City:DEPUTY
Mailing Address - State:IN
Mailing Address - Zip Code:47230-9117
Mailing Address - Country:US
Mailing Address - Phone:812-866-2769
Mailing Address - Fax:812-866-2769
Practice Address - Street 1:2698 N 1100 W
Practice Address - Street 2:
Practice Address - City:DEPUTY
Practice Address - State:IN
Practice Address - Zip Code:47230-9117
Practice Address - Country:US
Practice Address - Phone:812-866-2769
Practice Address - Fax:812-866-2769
Is Sole Proprietor?:No
Enumeration Date:2008-02-22
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39000674A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health