MEDICARE: MRS. YOLANDA KING LMSW

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	104100000X	Social Worker
2	1041C0700X	Clinical Social Worker	9607-C	NV
3	1041C0700X	Clinical Social Worker	6801086692	MI

General Provider Information

NPI Number	:	1144418898
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. YOLANDA KING LMSW

Provider Business Mailing Address
First Line	:	3925 S JONES BLVD APT 1070
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-7105
Country	:	US
Telephone Number	:	702-290-0740
Fax Number	:

Provider Business Practice Location Address
First Line	:	7341 W CHARLESTON BLVD STE 110
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-1573
Country	:	US
Telephone Number	:	725-251-5916
Fax Number	:

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

Provider Enumeration Date	:	10/09/2007
Last Update Date	:	12/19/2024

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