Provider Demographics
NPI:1508670829
Name:KING, ASHLEY M
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:M
Last Name:KING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 ENWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28214-1219
Mailing Address - Country:US
Mailing Address - Phone:704-491-8970
Mailing Address - Fax:
Practice Address - Street 1:7300 CARMEL EXECUTIVE PARK DR STE 115
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-1310
Practice Address - Country:US
Practice Address - Phone:704-491-8970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-05
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC00644106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist