Provider Demographics
NPI:1629305099
Name:LOUIS S. KLEIN P.C.
Entity Type:Organization
Organization Name:LOUIS S. KLEIN P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:S
Authorized Official - Last Name:KLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:248-661-0966
Mailing Address - Street 1:31000 OAK VALLEY DRIVE
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48331-1204
Mailing Address - Country:US
Mailing Address - Phone:248-661-0966
Mailing Address - Fax:
Practice Address - Street 1:31000 OAK VALLEY DRIVE
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48331-1204
Practice Address - Country:US
Practice Address - Phone:248-661-0966
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LOUIS S. KLEIN, PH.D., P.C
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-11-05
Last Update Date:2009-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301000315103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0F34827Medicare UPIN