Provider Demographics
NPI:1164553244
Name:KING, LOUVADIE S (MS)
Entity Type:Individual
Prefix:MRS
First Name:LOUVADIE
Middle Name:S
Last Name:KING
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1434 SINGING TREES DR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38116-4348
Mailing Address - Country:US
Mailing Address - Phone:901-396-7214
Mailing Address - Fax:901-323-3640
Practice Address - Street 1:1434 SINGING TREES DR
Practice Address - Street 2:111 RACINE ST.
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38116-4348
Practice Address - Country:US
Practice Address - Phone:901-323-3600
Practice Address - Fax:901-323-3640
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPC0000001666101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health