Provider Demographics
NPI:1518488089
Name:KING, LAURA BETH (LPC, NCC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:BETH
Last Name:KING
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 CROSSING DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:GA
Mailing Address - Zip Code:31324-3942
Mailing Address - Country:US
Mailing Address - Phone:706-573-4194
Mailing Address - Fax:
Practice Address - Street 1:14 CROSSING DR
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:GA
Practice Address - Zip Code:31324-3942
Practice Address - Country:US
Practice Address - Phone:706-573-4194
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC008975101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional