MEDICARE: LORI L KING LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	C.1700753	OH

General Provider Information

NPI Number	:	1003327651
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORI L KING LPC

Provider Business Mailing Address
First Line	:	951 MONTFORD RD
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44121-2077
Country	:	US
Telephone Number	:	919-368-2767
Fax Number	:

Provider Business Practice Location Address
First Line	:	951 MONTFORD RD
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44121-2077
Country	:	US
Telephone Number	:	919-368-2767
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/21/2017
Last Update Date	:	10/21/2017

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Directions to “ LORI L KING LPC” Practice Location

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