=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770295008
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KESSA KING
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/19/2022
-----------------------------------------------------
Last Update Date | 12/09/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2045 WESTGATE DR STE 206
-----------------------------------------------------
City | BETHLEHEM
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18017-7475
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-596-4222
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1225 BROAD ST APT 8
-----------------------------------------------------
City | WHITEHALL
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18052-4954
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101Y00000X
-----------------------------------------------------
Taxonomy Name | Counselor
-----------------------------------------------------
License Number | APC001910
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------