Provider Demographics
NPI:1891891800
Name:KLEVEN, SANDRA L (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:L
Last Name:KLEVEN
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 1:3978 DEFIANCE ST
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99504-4480
Mailing Address - Country:US
Mailing Address - Phone:907-332-6735
Mailing Address - Fax:
Practice Address - Street 1:550 W 8TH AVE
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99501-3518
Practice Address - Country:US
Practice Address - Phone:907-332-6735
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK2571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical