Healthcare Provider Details

I. General information

NPI: 1891605200
Provider Name (Legal Business Name): LILY KING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 CHASE PARK S STE 202
HOOVER AL
35244-1800
US

IV. Provider business mailing address

2708 TODD CIR SW
DECATUR AL
35603-2478
US

V. Phone/Fax

Practice location:
  • Phone: 256-654-1857
  • Fax:
Mailing address:
  • Phone: 256-654-1857
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberALC06188
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: