King, Edward Cecil

King, Edward Cecil is an individual health care provider with primary practice located at 1690 Dunlawton Ave Suite 125, Port Orange FL 32127-8979. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is his primary health care specialty. King, Edward Cecil can be contacted via phone (386) 236-9271.

Contact Information

Primary practice address
1690 Dunlawton Ave Suite 125 Port Orange FL 32127-8979
Phone: (386) 236-9271
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 10520 Florida
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 10520 Florida

Profile Details

NPI number 1659623213
LBN Legal business name King, Edward Cecil
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 8th, 2012
Last updated Jun 14th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659623213 NPPES
Florida MEDICAID 023145400

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