Healthcare Provider Details

I. General information

NPI: 1376993329
Provider Name (Legal Business Name): MELINDA KAY KING LPCMH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2016
Last Update Date: 02/12/2024
Certification Date: 02/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 SAULSBURY RD STE D
DOVER DE
19904-3472
US

IV. Provider business mailing address

4799 S STATE ST
MAGNOLIA DE
19962-1498
US

V. Phone/Fax

Practice location:
  • Phone: 302-336-8019
  • Fax: 302-269-3958
Mailing address:
  • Phone: 302-535-2620
  • Fax: 302-269-3958

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberPC0000782
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPC0000782
License Number StateDE
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC-0000782
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: