Provider Demographics
NPI:1700911245
Name:KLEIN, RANDI E (LICSW CADAC)
Entity Type:Individual
Prefix:MS
First Name:RANDI
Middle Name:E
Last Name:KLEIN
Suffix:
Gender:F
Credentials:LICSW CADAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:167 DWIGHT RD STE 104
Mailing Address - Street 2:THERAPEUTIC ASSOCIATES PC
Mailing Address - City:LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01106-1769
Mailing Address - Country:US
Mailing Address - Phone:413-567-5533
Mailing Address - Fax:413-567-9010
Practice Address - Street 1:167 DWIGHT RD STE 104
Practice Address - Street 2:THERAPEUTIC ASSOCIATES PC
Practice Address - City:LONGMEADOW
Practice Address - State:MA
Practice Address - Zip Code:01106-1769
Practice Address - Country:US
Practice Address - Phone:413-567-5533
Practice Address - Fax:413-567-9010
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1072521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical