| Doctor Name: | KEVIN L CLINE |
| NPI Number: | 1003034463 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LISW |
| License Number: | I.0004042 |
| Business Practice Address: | 520 N Chestnut St Ravenna, OH - 442662218 |
| Business Phone Number: | 3302965552 |
| Business Fax Number: | 3302966126 |
| Mailing Address: | 1430 Lake Martin Dr, KENT |
| State: | OH |
| Postal Code: | 442406260 |
| Phone Number: | 3306265908 |
| Fax Number: | |
| NPI Enumeration Date: | 04/23/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | I.0004042 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |