Provider Demographics
NPI:1215369277
Name:KING, ROBERT M II (MA, LPC, CAADC)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:M
Last Name:KING
Suffix:II
Gender:M
Credentials:MA, LPC, CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:731 E MOUNT MORRIS ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT MORRIS
Mailing Address - State:MI
Mailing Address - Zip Code:48458-2070
Mailing Address - Country:US
Mailing Address - Phone:810-547-1472
Mailing Address - Fax:810-368-4936
Practice Address - Street 1:731 E MOUNT MORRIS ST STE 6
Practice Address - Street 2:
Practice Address - City:MOUNT MORRIS
Practice Address - State:MI
Practice Address - Zip Code:48458-2070
Practice Address - Country:US
Practice Address - Phone:810-547-1472
Practice Address - Fax:810-368-4936
Is Sole Proprietor?:No
Enumeration Date:2013-08-01
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
MI6401014306101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)