Provider Demographics
NPI:1689364549
Name:KING, DARWIN JAY (LCSW)
Entity Type:Individual
Prefix:
First Name:DARWIN
Middle Name:JAY
Last Name:KING
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 2ND AVE SW
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:OK
Mailing Address - Zip Code:74354-6818
Mailing Address - Country:US
Mailing Address - Phone:918-542-6412
Mailing Address - Fax:918-542-6482
Practice Address - Street 1:203 2ND AVE SW
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:OK
Practice Address - Zip Code:74354-6818
Practice Address - Country:US
Practice Address - Phone:918-542-6412
Practice Address - Fax:918-542-6482
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-12
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK25841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical