MEDICARE: DANIEL ERWIN KING LCDC-III

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	LCDCIII.162187	OH

General Provider Information

NPI Number	:	1912441056
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL ERWIN KING LCDC-III

Provider Business Mailing Address
First Line	:	215 N FRONT ST STE 510
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43215-3376
Country	:	US
Telephone Number	:	614-372-3110
Fax Number	:

Provider Business Practice Location Address
First Line	:	81 S 5TH ST
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43215-4325
Country	:	US
Telephone Number	:	614-362-4862
Fax Number	:

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

Provider Enumeration Date	:	12/08/2016
Last Update Date	:	12/09/2025

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