Provider Demographics
NPI:1376009209
Name:KING, ZAIRE ELISSA (MA, LMFTA)
Entity Type:Individual
Prefix:MRS
First Name:ZAIRE
Middle Name:ELISSA
Last Name:KING
Suffix:
Gender:F
Credentials:MA, LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 N CHARLOTTE AVE STE A105
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28110-2525
Mailing Address - Country:US
Mailing Address - Phone:704-698-7934
Mailing Address - Fax:855-698-7934
Practice Address - Street 1:1501 N CHARLOTTE AVE STE A105
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28110-2525
Practice Address - Country:US
Practice Address - Phone:704-698-7934
Practice Address - Fax:855-698-7934
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-15
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12275A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist