Provider Demographics
NPI:1801921200
Name:KLINE, LOUISE A (MSSA LISW RN)
Entity type:Individual
Prefix:MS
First Name:LOUISE
Middle Name:A
Last Name:KLINE
Suffix:
Gender:F
Credentials:MSSA LISW RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 NORTH WOODS COURT
Mailing Address - Street 2:#4
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44483
Mailing Address - Country:US
Mailing Address - Phone:330-399-4661
Mailing Address - Fax:330-393-5975
Practice Address - Street 1:318 MAHONING AVENUE NW
Practice Address - Street 2:VALLEY COUNSELING SERVICES
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44483
Practice Address - Country:US
Practice Address - Phone:330-395-9563
Practice Address - Fax:330-393-5975
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0010103104100000X
OHRN112500163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000321089OtherANTHEM