Healthcare Provider Details

I. General information

NPI: 1467367540
Provider Name (Legal Business Name): TIMOTHY RAY KING LMSW, DSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1307 WESTLAWN BLVD APT 618
MURFREESBORO TN
37128-1803
US

IV. Provider business mailing address

1307 WESTLAWN BLVD APT 618
MURFREESBORO TN
37128-1803
US

V. Phone/Fax

Practice location:
  • Phone: 931-224-8609
  • Fax:
Mailing address:
  • Phone: 931-224-8609
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number8826
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: