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General NPI Number Information
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NPI Number | 1043359193
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Entity Type | Individual
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Provider Name | LISA MARIE KING PSY.D., MSW, LP, CAP
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Gender | Female
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 11/09/2015
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Provider Practice Location Address
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Address Line | 950 6TH AVE N
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City | NAPLES
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State | FL
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Zip | 34102-5633
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Country | US
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Telephone | 239-659-2345
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Fax |
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Provider Business Mailing Address
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Address Line | 950 6TH AVE N
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City | NAPLES
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State | FL
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Zip | 34102-5633
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Country | US
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Telephone | 239-659-2345
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 6801078040
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 6801078040
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801078040
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY9434
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 103TA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Psychologist
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License Number | PY9434
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License Number State | FL
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Taxonomy #6
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | PY9434
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License Number State | FL
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Taxonomy #7
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 010141-2015
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License Number State | FL
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