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:
Health care specialties
| Specialty | Code | License # | 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 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659623213 | NPPES |
| Florida | MEDICAID | 023145400 |
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