MEDICARE: MR. LEE KING LCSW, LADAC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	4878	NM
2	101YM0800X	Mental Health Counselor	C-11557	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801051867
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. LEE KING LCSW, LADAC

Provider Business Mailing Address
First Line	:	PO BOX 1078
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88004-1078
Country	:	US
Telephone Number	:	575-518-4011
Fax Number	:

Provider Business Practice Location Address
First Line	:	1001 N SOLANO DR STE A
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88001-2366
Country	:	US
Telephone Number	:	575-518-4011
Fax Number	:

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

Provider Enumeration Date	:	07/18/2008
Last Update Date	:	08/14/2025

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