Provider Demographics
NPI:1912552001
Name:KING & SAMSON CONSULTING SERVICES LLC
Entity Type:Organization
Organization Name:KING & SAMSON CONSULTING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ZACHERY
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:SAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-657-1241
Mailing Address - Street 1:831 E 7TH ST
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:WY
Mailing Address - Zip Code:82801-3106
Mailing Address - Country:US
Mailing Address - Phone:801-657-1241
Mailing Address - Fax:
Practice Address - Street 1:831 E 7TH ST
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:WY
Practice Address - Zip Code:82801-3106
Practice Address - Country:US
Practice Address - Phone:801-657-1241
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-06
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty