Provider Demographics
NPI:1013221746
Name:KING, ANNE M (MAC, PC, LSW)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:M
Last Name:KING
Suffix:
Gender:F
Credentials:MAC, PC, LSW
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 1058
Mailing Address - Street 2:
Mailing Address - City:CIRCLEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43113-5058
Mailing Address - Country:US
Mailing Address - Phone:740-477-8877
Mailing Address - Fax:
Practice Address - Street 1:24 S MULBERRY ST
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-3325
Practice Address - Country:US
Practice Address - Phone:800-323-7174
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-05
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.0700036101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional