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General NPI Number Information
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NPI Number | 1013236751
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Entity Type | Organization
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Legal Business Name | KING CLINICAL & FORENSIC PSYCHOLOGY, LLC
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Dates
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Enumeration Date | 05/20/2010
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Last Update Date | 07/07/2011
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Provider Practice Location Address
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Address Line | 9601 GAYTON RD STE 201
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City | RICHMOND
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State | VA
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Zip | 23238-4963
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Country | US
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Telephone | 804-380-8940
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Fax | 202-204-8461
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Provider Business Mailing Address
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Address Line | 9601 GAYTON RD STE 201
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City | RICHMOND
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State | VA
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Zip | 23238-4963
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Country | US
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Telephone | 804-380-8940
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Fax | 202-204-8461
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Authorized Official
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Title or Position | PSYCHOLOGIST/OWNER
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Name | DR. CRAIG S KING
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Credential | PSY. D., M.S.W.
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Telephone | 804-380-8940
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY1000301
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 04362
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 0810003497
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License Number State | VA
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