Healthcare Provider Details

I. General information

NPI: 1962756486
Provider Name (Legal Business Name): AMBER LYNN KING LPC, M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2012
Last Update Date: 06/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 GEORGIAN PL
SOMERSET PA
15501-1611
US

IV. Provider business mailing address

2609 COPPER KETTLE HWY
ROCKWOOD PA
15557-7205
US

V. Phone/Fax

Practice location:
  • Phone: 814-444-0620
  • Fax: 814-444-0640
Mailing address:
  • Phone: 814-444-0620
  • Fax: 814-444-0640

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC006992
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: