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General NPI Number Information
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NPI Number | 1396273892
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Entity Type | Individual
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Provider Name | ANGELA KING LMSW, LSAA
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Gender | Female
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Dates
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Enumeration Date | 05/26/2017
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 7 MUNICIPAL WAY
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City | EDGEWOOD
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State | NM
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Zip | 87015-7210
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Country | US
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Telephone | 505-281-3406
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Fax |
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Provider Business Mailing Address
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Address Line | 91 MADRID AVE
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City | MORIARTY
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State | NM
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Zip | 87035-5355
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Country | US
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Telephone | 580-665-2044
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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 | CSA0211931
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | SWB-2024-0766
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License Number State | NM
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