MEDICARE: LAUREN THOMAS 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	104100000X	Social Worker	10100	SC

General Provider Information

NPI Number	:	1609297084
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN THOMAS KING

Provider Business Mailing Address
First Line	:	3876 RENEE DR UNIT C
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29579-4108
Country	:	US
Telephone Number	:	843-504-8346
Fax Number	:

Provider Business Practice Location Address
First Line	:	3876 RENEE DR UNIT C
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29579-4108
Country	:	US
Telephone Number	:	843-504-8346
Fax Number	:

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

Provider Enumeration Date	:	01/02/2014
Last Update Date	:	03/13/2024

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Directions to “ LAUREN THOMAS KING ” Practice Location

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