Provider Demographics
NPI:1437186186
Name:KING, DAVID S (PHD, LPC, NCC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:S
Last Name:KING
Suffix:
Gender:M
Credentials:PHD, LPC, NCC
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 323
Mailing Address - Street 2:
Mailing Address - City:SOUTH MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:27976-0323
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:109 TAYLOR LEIGH DR
Practice Address - Street 2:
Practice Address - City:SOUTH MILLS
Practice Address - State:NC
Practice Address - Zip Code:27976-9427
Practice Address - Country:US
Practice Address - Phone:252-771-3283
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2271101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health