Provider Demographics
NPI:1053190694
Name:KLEINE, STEPHEN (LPC-ASSOCIATE, LCDC)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:KLEINE
Suffix:
Gender:M
Credentials:LPC-ASSOCIATE, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:722 TACOMA DR
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-2738
Mailing Address - Country:US
Mailing Address - Phone:214-664-6322
Mailing Address - Fax:
Practice Address - Street 1:3600 SHIRE BLVD STE 208
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-2238
Practice Address - Country:US
Practice Address - Phone:214-556-0996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16476101YA0400X
TX91354101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)