Provider Demographics
NPI:1013236751
Name:KING CLINICAL & FORENSIC PSYCHOLOGY, LLC
Entity Type:Organization
Organization Name:KING CLINICAL & FORENSIC PSYCHOLOGY, LLC
Other - Org Name:KCFP, LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:PSYCHOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:S
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:PSY D, MSW
Authorized Official - Phone:804-380-8940
Mailing Address - Street 1:9601 GAYTON RD STE 201
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23238-4963
Mailing Address - Country:US
Mailing Address - Phone:804-380-8940
Mailing Address - Fax:202-204-8461
Practice Address - Street 1:9601 GAYTON RD STE 201
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23238-4963
Practice Address - Country:US
Practice Address - Phone:804-380-8940
Practice Address - Fax:202-204-8461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-20
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPSY1000301103TC0700X
MD04362103TC0700X
VA0810003497103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty