Provider Demographics
NPI:1700468360
Name:KING, TABITHA (LCSW)
Entity Type:Individual
Prefix:
First Name:TABITHA
Middle Name:
Last Name:KING
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:TABITHA
Other - Middle Name:
Other - Last Name:ESPINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:428 E SECO DR
Mailing Address - Street 2:
Mailing Address - City:HOBBS
Mailing Address - State:NM
Mailing Address - Zip Code:88240-4028
Mailing Address - Country:US
Mailing Address - Phone:575-441-5424
Mailing Address - Fax:
Practice Address - Street 1:907 W CALLE SUR ST
Practice Address - Street 2:
Practice Address - City:HOBBS
Practice Address - State:NM
Practice Address - Zip Code:88240-1300
Practice Address - Country:US
Practice Address - Phone:505-318-6771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-23
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1053901041C0700X
NMSWB-2024-03521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical