Provider Demographics
NPI:1477179703
Name:KING, KATHRYN (PLPC)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:KING
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 STONEBURG DR
Mailing Address - Street 2:
Mailing Address - City:DUSON
Mailing Address - State:LA
Mailing Address - Zip Code:70529-3947
Mailing Address - Country:US
Mailing Address - Phone:985-859-9137
Mailing Address - Fax:
Practice Address - Street 1:222 STONEBURG DR
Practice Address - Street 2:
Practice Address - City:DUSON
Practice Address - State:LA
Practice Address - Zip Code:70529-3947
Practice Address - Country:US
Practice Address - Phone:985-859-9137
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-23
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
LAPLC8661101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator