Provider Demographics
NPI:1700813193
Name:KLEIN, CATHERINE TRAYNOR (LCSWC)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:TRAYNOR
Last Name:KLEIN
Suffix:
Gender:F
Credentials:LCSWC
Other - Prefix:MS
Other - First Name:CATHERINE
Other - Middle Name:
Other - Last Name:TRAYNOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSWC
Mailing Address - Street 1:5407 N CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21210-2024
Mailing Address - Country:US
Mailing Address - Phone:410-433-8861
Mailing Address - Fax:410-433-1249
Practice Address - Street 1:5407 N CHARLES ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21210-2024
Practice Address - Country:US
Practice Address - Phone:410-433-8861
Practice Address - Fax:410-433-1249
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD10607104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
330039OtherTRICARE
P00079961OtherMEDICARE RAILROAD
0011OtherFED BC
226412OtherKAISER
543998000OtherMAGELLAN
200149OtherJOHN HOPKINS HEALTH CARE
221855OtherCOM PSYCH
D188Medicare ID - Type Unspecified