Provider Demographics
NPI:1740874924
Name:KLEIN, SHARON (QMHS)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:KLEIN
Suffix:
Gender:F
Credentials:QMHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28407 STATE ROUTE 7
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-5152
Mailing Address - Country:US
Mailing Address - Phone:740-371-5476
Mailing Address - Fax:740-371-5494
Practice Address - Street 1:28407 STATE ROUTE 7
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750-5152
Practice Address - Country:US
Practice Address - Phone:740-371-5476
Practice Address - Fax:740-371-5494
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-27
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
OHCDCA.186430101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst