Provider Demographics
NPI:1750521886
Name:KING, NAN (LMHC, CADC, LLC)
Entity type:Individual
Prefix:
First Name:NAN
Middle Name:
Last Name:KING
Suffix:
Gender:
Credentials:LMHC, CADC, LLC
Other - Prefix:
Other - First Name:NANETTE
Other - Middle Name:
Other - Last Name:KING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMHC, CADC, LLC
Mailing Address - Street 1:323 E WALNUT ST
Mailing Address - Street 2:STE 304
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-2026
Mailing Address - Country:US
Mailing Address - Phone:515-778-4440
Mailing Address - Fax:515-285-3943
Practice Address - Street 1:323 E WALNUT ST
Practice Address - Street 2:STE 304
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-2026
Practice Address - Country:US
Practice Address - Phone:515-778-4440
Practice Address - Fax:515-285-3943
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-02
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA8043101YA0400X
IA1059101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)