Healthcare Provider Details

I. General information

NPI: 1073400479
Provider Name (Legal Business Name): CARLI KING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2025
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 LANCEWOOD DR
PITTSBURGH PA
15235-5015
US

IV. Provider business mailing address

25 LANCEWOOD DR
PITTSBURGH PA
15235-5015
US

V. Phone/Fax

Practice location:
  • Phone: 412-759-3583
  • Fax:
Mailing address:
  • Phone: 412-759-3583
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CARLI KING
Title or Position: OWNER
Credential: LMFT
Phone: 412-759-3583