Provider Demographics
NPI:1700373362
Name:KLEIN, ERIC SCOTT (LSW)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:SCOTT
Last Name:KLEIN
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84 FREEDOM TER
Mailing Address - Street 2:
Mailing Address - City:PALMER
Mailing Address - State:PA
Mailing Address - Zip Code:18045-7442
Mailing Address - Country:US
Mailing Address - Phone:215-913-5395
Mailing Address - Fax:
Practice Address - Street 1:299 INDUSTRIAL DRIVE
Practice Address - Street 2:
Practice Address - City:NAZARETH
Practice Address - State:PA
Practice Address - Zip Code:18064
Practice Address - Country:US
Practice Address - Phone:610-504-6122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-19
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW133613104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker