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NPI Code Detail

MEDICARE: LATAI KING LCPC, LCADC, QMHP

MEDICARE:   LATAI  KING  LCPC, LCADC, QMHP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorCP1202NV

General Provider Information

NPI Number : 1487951752
Entity Type Code : Individual
Provider Name (Legal Business Name) : LATAI KING LCPC, LCADC, QMHP
Provider Business Mailing Address
First Line : 9466 BLOOMING GROVE AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89149-1697
Country : US
Telephone Number : 702-328-0225
Fax Number :
Provider Business Practice Location Address
First Line : 3235 S EASTERN AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89169-3310
Country : US
Telephone Number : 702-490-9009
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2011
Last Update Date : 09/01/2019

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Directions to “ LATAI KING LCPC, LCADC, QMHP” Practice Location

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