Provider Demographics
NPI:1659393072
Name:KLEIN, LARRY S (MSW)
Entity Type:Individual
Prefix:MR
First Name:LARRY
Middle Name:S
Last Name:KLEIN
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 CRESTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:GLEN ROCK
Mailing Address - State:NJ
Mailing Address - Zip Code:07452-2908
Mailing Address - Country:US
Mailing Address - Phone:201-447-3373
Mailing Address - Fax:201-447-3393
Practice Address - Street 1:55 WATER ST
Practice Address - Street 2:12TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10041-0004
Practice Address - Country:US
Practice Address - Phone:646-447-7266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051596-11041C0700X
NJ44SC045360001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical