Provider Demographics
NPI:1609459965
Name:KLEIN, DANIEL GILBERT JR (LCSW)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:GILBERT
Last Name:KLEIN
Suffix:JR
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 FERRARO ST APT 1
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01604-2614
Mailing Address - Country:US
Mailing Address - Phone:508-762-8911
Mailing Address - Fax:
Practice Address - Street 1:4 MANN ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01602-3414
Practice Address - Country:US
Practice Address - Phone:508-948-9112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-04
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2259031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical