Provider Demographics
NPI:1538328430
Name:KING CITY COUNSELING CENTER
Entity Type:Organization
Organization Name:KING CITY COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCRAE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-658-3811
Mailing Address - Street 1:PO BOX 3076
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93942-3076
Mailing Address - Country:US
Mailing Address - Phone:831-658-3811
Mailing Address - Fax:831-658-3815
Practice Address - Street 1:522 BROADWAY ST
Practice Address - Street 2:SUITE B
Practice Address - City:KING CITY
Practice Address - State:CA
Practice Address - Zip Code:93930-3243
Practice Address - Country:US
Practice Address - Phone:831-385-3628
Practice Address - Fax:831-385-3711
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMMUNITY HUMAN SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-06-05
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health