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General NPI Number Information
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NPI Number | 1255228607
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Entity Type | Individual
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Provider Name | KRISTEN MARIE KING CSAC-A
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Gender | Female
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Dates
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Enumeration Date | 06/19/2025
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Last Update Date | 06/19/2025
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Provider Practice Location Address
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Address Line | 5322 LADYSMITH RD
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City | RUTHER GLEN
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State | VA
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Zip | 22546-1325
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Country | US
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Telephone | 888-887-6867
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Fax |
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Provider Business Mailing Address
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Address Line | 7 DORIA HILL DR
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City | STAFFORD
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State | VA
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Zip | 22554-9456
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Country | US
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Telephone | 703-986-9876
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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 | 0711000764
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License Number State | VA
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