Provider Demographics
NPI:1801546254
Name:KING, MICHAEL (LMFT)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:KING
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16015 ARROWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:RALPH
Mailing Address - State:AL
Mailing Address - Zip Code:35480
Mailing Address - Country:US
Mailing Address - Phone:205-826-4445
Mailing Address - Fax:
Practice Address - Street 1:2201 JACK WARNER PKWY
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35401-1090
Practice Address - Country:US
Practice Address - Phone:205-737-4658
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-28
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALL580106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist