Provider Demographics
NPI:1659161032
Name:KING, OLIVIA (LAC)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:KING
Suffix:
Gender:
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 MASSACHUSETTS AVE
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08629-1520
Mailing Address - Country:US
Mailing Address - Phone:609-331-0481
Mailing Address - Fax:609-331-0481
Practice Address - Street 1:2277 ROUTE 33 STE 408
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08690-1700
Practice Address - Country:US
Practice Address - Phone:732-851-4808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00861400101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health