Provider Demographics
NPI:1689810608
Name:KING, JULIET
Entity Type:Individual
Prefix:MS
First Name:JULIET
Middle Name:
Last Name:KING
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:JULIET
Other - Middle Name:
Other - Last Name:KING-MCCALLUM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, ATR-BC, LPC
Mailing Address - Street 1:304 NEWTON AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:OAKLYN
Mailing Address - State:NJ
Mailing Address - Zip Code:08107-1446
Mailing Address - Country:US
Mailing Address - Phone:856-858-2800
Mailing Address - Fax:856-858-2866
Practice Address - Street 1:304 NEWTON AVE FL 1
Practice Address - Street 2:
Practice Address - City:OAKLYN
Practice Address - State:NJ
Practice Address - Zip Code:08107-1446
Practice Address - Country:US
Practice Address - Phone:856-858-2800
Practice Address - Fax:856-858-2866
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-22
Last Update Date:2008-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00357100101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional