Provider Demographics
NPI:1346574563
Name:KING, DAVID SCOTT (MA, MSW)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:SCOTT
Last Name:KING
Suffix:
Gender:M
Credentials:MA, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9860 DUNDEE AZALIA RD
Mailing Address - Street 2:
Mailing Address - City:MAYBEE
Mailing Address - State:MI
Mailing Address - Zip Code:48159-9681
Mailing Address - Country:US
Mailing Address - Phone:734-657-8717
Mailing Address - Fax:
Practice Address - Street 1:3131 S STATE ST STE 226
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-1658
Practice Address - Country:US
Practice Address - Phone:734-439-3100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-21
Last Update Date:2022-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010669631041C0700X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical