Provider Demographics
NPI:1659391845
Name:KLINE, ROSE LAWYER (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ROSE
Middle Name:LAWYER
Last Name:KLINE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5159 HIGHWAY 4 E
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:LA
Mailing Address - Zip Code:71418-3581
Mailing Address - Country:US
Mailing Address - Phone:318-649-3625
Mailing Address - Fax:318-649-5731
Practice Address - Street 1:5159 HIGHWAY 4 E
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:LA
Practice Address - Zip Code:71418-3581
Practice Address - Country:US
Practice Address - Phone:318-649-3625
Practice Address - Fax:318-649-5731
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA17201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA3A071CX12Medicare PIN