Provider Demographics
NPI:1053412254
Name:FRANK, BERTON KLEIN (LCSWR)
Entity type:Individual
Prefix:MR
First Name:BERTON
Middle Name:KLEIN
Last Name:FRANK
Suffix:
Gender:M
Credentials:LCSWR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 HORSESHOE HILL RD
Mailing Address - Street 2:
Mailing Address - City:POUND RIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:10576
Mailing Address - Country:US
Mailing Address - Phone:914-764-0350
Mailing Address - Fax:914-764-0350
Practice Address - Street 1:185 ADAMS ST
Practice Address - Street 2:
Practice Address - City:BEDFORD HILLS
Practice Address - State:NY
Practice Address - Zip Code:10507
Practice Address - Country:US
Practice Address - Phone:914-764-0350
Practice Address - Fax:914-764-0350
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0280241041C0700X
NYR02802411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
1611193OtherOXFORD
7445052OtherMANAGED CHOICE
195595OtherMHN
14R028024CT02OtherANTHEM
400429OtherGHI
2537085OtherAETNA
828290OtherFIRST HEALTH
N44321OtherEMPIRE