MEDICARE: MATTHEW KING

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	101YM0800X	Mental Health Counselor	0704018823	VA

General Provider Information

NPI Number	:	1184557845
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW KING

Provider Business Mailing Address
First Line	:	4844 LITTLE BEAR RD
Second Line	:
City	:	SALEM
State	:	VA
Zip	:	24153-7942
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 E BURWELL ST STE B
Second Line	:
City	:	SALEM
State	:	VA
Zip	:	24153-4329
Country	:	US
Telephone Number	:	540-375-7307
Fax Number	:

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

Provider Enumeration Date	:	06/04/2026
Last Update Date	:	06/04/2026

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Directions to “ MATTHEW KING ” Practice Location

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