Michael King LCSW LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW006094 Issued in GA

Legal business name

MICHAEL KING LCSW LLC

Practice address

201 Cove Rd
Jasper, GA 30143-1356

Phone

(706) 253-9515

Fax

(706) 253-9516

NPI assigned

May 25, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michael Estel King, LCSWNPI 1386172047

Title

Sole Proprietor

Phone

(706) 669-3526

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Estel King, LCSW

  • Clinical Social Worker
  • Jasper, GA
  • NPI 1386172047
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1495670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1578091252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 COVE RD",
            "city": "JASPER",
            "state": "GA",
            "postal_code": "301431356",
            "telephone_number": "706-253-9515",
            "fax_number": "706-253-9516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 COVE RD",
            "city": "JASPER",
            "state": "GA",
            "postal_code": "301431356",
            "telephone_number": "706-253-9515",
            "fax_number": "706-253-9516"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "113 Mountain Brook Dr Ste 104",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "GA",
            "postal_code": "301159057",
            "country_code": "US",
            "telephone_number": "706-669-3526",
            "fax_number": "706-253-9516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MICHAEL KING LCSW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-25",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "ESTEL",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "706-669-3526",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW006094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Holly Wilson Mitchell, RN, CNM
• Robert Lacour Mitchell, MD
• William Thomas Mixon, PT, DPT

• Clinical Social Worker in Jasper, GA
• Providers in Jasper, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.