Provider Demographics
NPI:1598840894
Name:KLEIN, SARA JO (LMHP)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:JO
Last Name:KLEIN
Suffix:
Gender:F
Credentials:LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2027 10TH ST
Mailing Address - Street 2:
Mailing Address - City:GERING
Mailing Address - State:NE
Mailing Address - Zip Code:69341-2417
Mailing Address - Country:US
Mailing Address - Phone:308-632-4200
Mailing Address - Fax:308-632-4205
Practice Address - Street 1:2027 10TH ST
Practice Address - Street 2:
Practice Address - City:GERING
Practice Address - State:NE
Practice Address - Zip Code:69341-2417
Practice Address - Country:US
Practice Address - Phone:308-632-4200
Practice Address - Fax:308-632-4205
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE7782101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025752900Medicaid
NE84467OtherBCBS
NE253219OtherMIDLANDS