Active NPI
Mary Alice King, MS, LPES, LPC
- Psychologist
- Hartsville, SC
National Provider Identifier
1497245328
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 4567
- Practice address
- 513 Woodland Drive
Hartsville, SC 29550 - Phone
- (843) 858-3853
- NPI assigned
- May 16, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 2839 | SC | |
| Psychologist | 103T00000X | 4567 | SC | Primary |
Addresses
Primary practice location
513 Woodland Drive
Hartsville, SC 29550
Mailing address
513 Woodland Drive
Hartsville, SC 29550
Phone (843) 858-3853
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4567 | SC | MD | General Practice Dentistry |
| 2839 | SC | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1526428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1526428800000",
"number": "1497245328",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "513 WOODLAND DRIVE",
"city": "HARTSVILLE",
"state": "SC",
"postal_code": "29550",
"telephone_number": "843-858-3853"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "513 WOODLAND DRIVE",
"city": "HARTSVILLE",
"state": "SC",
"postal_code": "29550",
"telephone_number": "843-858-3853"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "MARY",
"middle_name": "ALICE",
"name_prefix": "Mrs.",
"credential": "MS, LPES, LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-16",
"last_updated": "2018-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "SC",
"license": "2839",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "SC",
"license": "4567",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hartsville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.