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General NPI Number Information
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NPI Number | 1528264108
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Entity Type | Individual
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Provider Name | SHAWN DAVID KING PHD, LISWS
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Gender | Male
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Dates
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Enumeration Date | 06/21/2007
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Last Update Date | 10/17/2023
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Provider Practice Location Address
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Address Line | 53 MAY AVENUE
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City | CHAUNCEY
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State | OH
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Zip | 45719
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Country | US
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Telephone | 740-856-8767
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 176
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City | CHAUNCEY
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State | OH
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Zip | 45719-0176
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Country | US
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Telephone | 740-856-8767
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Fax | 740-589-5701
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I.1101401-SUPV
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License Number State | OH
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