Provider Demographics
NPI:1639726599
Name:KING, TARA (LMSW)
Entity Type:Individual
Prefix:MS
First Name:TARA
Middle Name:
Last Name:KING
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 VETERANS MEMORIAL PKWY APT 1013
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35404-4100
Mailing Address - Country:US
Mailing Address - Phone:205-310-3757
Mailing Address - Fax:
Practice Address - Street 1:722 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:BESSEMER
Practice Address - State:AL
Practice Address - Zip Code:35022-6099
Practice Address - Country:US
Practice Address - Phone:205-224-5400
Practice Address - Fax:205-428-8406
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-23
Last Update Date:2019-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3544G104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker