Individual provider Active NPI

Micheline Marie O'Haire Klein, LCSW

  • Clinical Social Worker
  • Jasper, GA
National Provider Identifier
1699917641
Registry record updated Jun 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW009767 Issued in GA
Practice address
175 Samaritan Dr
Jasper, GA 30143-1964
Phone
(706) 253-4633
NPI assigned
Apr 6, 2009
Last updated
Jun 1, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW009767 GA Primary

Addresses

Primary practice location

175 Samaritan Dr
Jasper, GA 30143-1964

Mailing address

175 Samaritan Dr
Jasper, GA 30143-1964
Phone (701) 625-3463

Other practice location 1

982 Stover Rd
Canton, GA 30115-4513
Phone (770) 647-1260

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CSW009767GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Stepping Forward Counseling Services, LLC Current Accepting new patients
Good Samaritan Health & Wellness Center Inc. PastSince Jul 13, 2025 Accepting new patients
Good Samaritan Health & Wellness Center Inc. PastSince Nov 9, 2025 Accepting new patients
Town of Islip Addiction (Substance Use Disorder) Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CJECDA

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1238976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780272000000",
    "number": "1699917641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 SAMARITAN DR",
            "city": "JASPER",
            "state": "GA",
            "postal_code": "301431964",
            "telephone_number": "701-625-3463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 SAMARITAN DR",
            "city": "JASPER",
            "state": "GA",
            "postal_code": "301431964",
            "telephone_number": "706-253-4633"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "982 Stover Rd",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "GA",
            "postal_code": "301154513",
            "country_code": "US",
            "telephone_number": "770-647-1260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLEIN",
        "first_name": "MICHELINE",
        "middle_name": "MARIE O'HAIRE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-06",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW009767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.