Healthcare Provider Details

I. General information

NPI: 1750027637
Provider Name (Legal Business Name): SINA KING-SMITH LPC, RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2022
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

709 BEECHURST AVE STE 14B
MORGANTOWN WV
26505-4689
US

IV. Provider business mailing address

709 BEECHURST AVE STE 14B
MORGANTOWN WV
26505-4689
US

V. Phone/Fax

Practice location:
  • Phone: 724-249-6230
  • Fax:
Mailing address:
  • Phone: 304-685-1524
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number3064
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number86033141
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: