Provider Demographics
NPI:1649327222
Name:KLINE, BRENDA MARIE (LICSW, MSW)
Entity type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:MARIE
Last Name:KLINE
Suffix:
Gender:F
Credentials:LICSW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 LONG DR
Mailing Address - Street 2:
Mailing Address - City:DRACUT
Mailing Address - State:MA
Mailing Address - Zip Code:01826-2048
Mailing Address - Country:US
Mailing Address - Phone:978-957-9214
Mailing Address - Fax:978-454-8615
Practice Address - Street 1:83 LONG DR
Practice Address - Street 2:
Practice Address - City:DRACUT
Practice Address - State:MA
Practice Address - Zip Code:01826-2048
Practice Address - Country:US
Practice Address - Phone:978-957-9214
Practice Address - Fax:978-454-8615
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1116351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical