Provider Demographics
NPI:1790091833
Name:CLEIN, JANICE (LMSW)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:CLEIN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4248 ROSEWOLD AVE
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-1921
Mailing Address - Country:US
Mailing Address - Phone:313-920-5619
Mailing Address - Fax:
Practice Address - Street 1:4248 ROSEWOLD AVE
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-1921
Practice Address - Country:US
Practice Address - Phone:313-920-5619
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-26
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010902061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical