Provider Demographics
NPI:1396763165
Name:KLINE-LASH, BEVERLY I (LPC)
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:I
Last Name:KLINE-LASH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 SNYDER AVENUE
Mailing Address - Street 2:
Mailing Address - City:BEAVER SPRINGS
Mailing Address - State:PA
Mailing Address - Zip Code:17812-3403
Mailing Address - Country:US
Mailing Address - Phone:570-658-7710
Mailing Address - Fax:570-658-7710
Practice Address - Street 1:730 SNYDER AVENUE
Practice Address - Street 2:
Practice Address - City:BEAVER SPRINGS
Practice Address - State:PA
Practice Address - Zip Code:17812-3403
Practice Address - Country:US
Practice Address - Phone:570-658-7710
Practice Address - Fax:570-658-7710
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004186101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional