Healthcare Provider Details

I. General information

NPI: 1750293635
Provider Name (Legal Business Name): TERESA KING LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 E 18TH ST
CEDAR FALLS IA
50613-4276
US

IV. Provider business mailing address

2307 ROYAL DR
CEDAR FALLS IA
50613-4457
US

V. Phone/Fax

Practice location:
  • Phone: 319-404-2800
  • Fax:
Mailing address:
  • Phone: 319-404-2800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number138223
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: