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NPI Code Detail

MEDICARE: MS. KAYLA KING LAC, MSW

MEDICARE: MS. KAYLA KING LAC, MSW
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
1101Y00000XCounselor6465ND
2101YA0400XAddiction (Substance Use Disorder) Counselor1814ND

General Provider Information

NPI Number : 1386161149
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KAYLA KING LAC, MSW
Provider Business Mailing Address
First Line : 1237 W DIVIDE AVE STE 5
Second Line :
City : BISMARCK
State : ND
Zip : 58501-1208
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1308 ELBOWOOD LN
Second Line :
City : BISMARCK
State : ND
Zip : 58503-5712
Country : US
Telephone Number : 701-751-8260
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2017
Last Update Date : 05/18/2023

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