Provider Demographics
NPI:1497903454
Name:KING, GEORGIA (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:GEORGIA
Middle Name:
Last Name:KING
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:MS
Other - First Name:CHARA
Other - Middle Name:JOY
Other - Last Name:RIEGEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6833B EASTERN AVE
Mailing Address - Street 2:APT. 37
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-4443
Mailing Address - Country:US
Mailing Address - Phone:301-836-1981
Mailing Address - Fax:
Practice Address - Street 1:8600 2ND AVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3326
Practice Address - Country:US
Practice Address - Phone:301-836-1981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-03
Last Update Date:2013-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MD182221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical