Provider Demographics
NPI:1700639556
Name:KING, JOSHUA NATHANIEL SR
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:NATHANIEL
Last Name:KING
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 HARRIS CREEK RD
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23669-1513
Mailing Address - Country:US
Mailing Address - Phone:757-371-5875
Mailing Address - Fax:757-726-2876
Practice Address - Street 1:35 HARRIS CREEK RD
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23669-1513
Practice Address - Country:US
Practice Address - Phone:757-723-1049
Practice Address - Fax:757-726-2876
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral