Provider Demographics
NPI:1639477565
Name:FREDRIC B. KLEINER, PH.D. & ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:FREDRIC B. KLEINER, PH.D. & ASSOCIATES, P.C.
Other - Org Name:THE RELATIONSHIP CENTER OF BETHESDA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FREDRIC
Authorized Official - Middle Name:BARRY
Authorized Official - Last Name:KLEINER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:301-652-2120
Mailing Address - Street 1:4401 E WEST HWY
Mailing Address - Street 2:SUITE 307
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-4523
Mailing Address - Country:US
Mailing Address - Phone:301-652-2120
Mailing Address - Fax:301-657-9224
Practice Address - Street 1:4401 E WEST HWY
Practice Address - Street 2:SUITE 307
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-4523
Practice Address - Country:US
Practice Address - Phone:301-652-2120
Practice Address - Fax:301-657-9224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-01
Last Update Date:2011-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD00640261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD9496009Medicaid
MD9496009Medicaid