Provider Demographics
NPI:1760963086
Name:KLEINFELDT, PAIGE DANIELLE (LCSW)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:DANIELLE
Last Name:KLEINFELDT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:PAIGE
Other - Middle Name:DANIELLE
Other - Last Name:FORSYTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:12 LOWER CENTER ST STE 15
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08809-1423
Mailing Address - Country:US
Mailing Address - Phone:908-396-6027
Mailing Address - Fax:
Practice Address - Street 1:12 LOWER CENTER ST STE 15
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NJ
Practice Address - Zip Code:08809-1423
Practice Address - Country:US
Practice Address - Phone:908-396-6027
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-24
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC056907001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical