Provider Demographics
NPI:1477684140
Name:KING, LORI (LPC/MHSP)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:
Last Name:KING
Suffix:
Gender:F
Credentials:LPC/MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:TN
Mailing Address - Zip Code:38260-5811
Mailing Address - Country:US
Mailing Address - Phone:405-227-5096
Mailing Address - Fax:
Practice Address - Street 1:1250 S MANUFACTURERS ROW
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:TN
Practice Address - Zip Code:38382
Practice Address - Country:US
Practice Address - Phone:731-855-7601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3443101YM0800X
TN4093101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health