Provider Demographics
NPI:1720323272
Name:KING, NANCY (LCSW)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:KING
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 RIVERSVILLE RD
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06831-3684
Mailing Address - Country:US
Mailing Address - Phone:203-531-1909
Mailing Address - Fax:203-531-7449
Practice Address - Street 1:7 RIVERSVILLE RD
Practice Address - Street 2:3RD FLOOR
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06831-3684
Practice Address - Country:US
Practice Address - Phone:203-531-1909
Practice Address - Fax:203-531-7449
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-10
Last Update Date:2012-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0040071041C0700X
NYR0407471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical