Provider Demographics
NPI:1730259193
Name:KLINE, KAREN SUE (PHD LMFT)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:SUE
Last Name:KLINE
Suffix:
Gender:F
Credentials:PHD LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 832
Mailing Address - Street 2:
Mailing Address - City:BALLWIN
Mailing Address - State:MO
Mailing Address - Zip Code:63011-1132
Mailing Address - Country:US
Mailing Address - Phone:817-692-3587
Mailing Address - Fax:484-694-3587
Practice Address - Street 1:180 S WEIDMAN RD
Practice Address - Street 2:STE. 121
Practice Address - City:MANCHESTER
Practice Address - State:MO
Practice Address - Zip Code:63021-4142
Practice Address - Country:US
Practice Address - Phone:636-686-0597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012040815106H00000X
TX4881106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist