Provider Demographics
NPI:1922287978
Name:KING, BARBARA SUE (MA, LPCC-S)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:SUE
Last Name:KING
Suffix:
Gender:F
Credentials:MA, LPCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 W WARD ST
Mailing Address - Street 2:
Mailing Address - City:URBANA
Mailing Address - State:OH
Mailing Address - Zip Code:43078-1633
Mailing Address - Country:US
Mailing Address - Phone:937-935-0831
Mailing Address - Fax:888-790-5071
Practice Address - Street 1:40 MONUMENT SQ
Practice Address - Street 2:
Practice Address - City:URBANA
Practice Address - State:OH
Practice Address - Zip Code:43078-2067
Practice Address - Country:US
Practice Address - Phone:937-935-0831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-26
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.0500749101YP2500X, 101YP2500X
374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No374U00000XNursing Service Related ProvidersHome Health Aide