Provider Demographics
NPI:1679626667
Name:KLEIN, AMELIA ROCCO (DSW, LCSW, LMFT,BCD)
Entity type:Individual
Prefix:DR
First Name:AMELIA
Middle Name:ROCCO
Last Name:KLEIN
Suffix:
Gender:F
Credentials:DSW, LCSW, LMFT,BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 WELLESLEY RD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19119-2931
Mailing Address - Country:US
Mailing Address - Phone:215-247-5690
Mailing Address - Fax:215-247-1043
Practice Address - Street 1:500 WELLESLEY RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19119-2931
Practice Address - Country:US
Practice Address - Phone:215-247-2819
Practice Address - Fax:215-247-1043
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW009278L1041C0700X
PAMF000303106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist