Healthcare Provider Details

I. General information

NPI: 1629433016
Provider Name (Legal Business Name): REGINA KING LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2015
Last Update Date: 02/18/2026
Certification Date: 02/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4951 CENTRAL AVE
MONROE LA
71203
US

IV. Provider business mailing address

850 KALISTE SALOOM RD STE 117
LAFAYETTE LA
70508-4230
US

V. Phone/Fax

Practice location:
  • Phone: 318-340-1535
  • Fax:
Mailing address:
  • Phone: 337-234-7109
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number5208
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number8890
License Number StateLA
# 3
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number8890
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: