Antonio King Jr., LSATP

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

0710103027 Issued in VA

Practice address

519 Xenia Ave
Dayton, OH 45410-1823

Phone

(937) 589-2277

NPI assigned

Jan 25, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Paragon Medical & Therapeutic Services of Ohio

  • Addiction (Substance Use Disorder) Counselor
  • Gloucester, VA
  • NPI 1235986431
  NPD Authorized official

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

{
    "created_epoch": "1579910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1639709918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 MEADOWLAKE RD",
            "city": "YORKTOWN",
            "state": "VA",
            "postal_code": "236933617",
            "telephone_number": "757-713-0385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 XENIA AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454101823",
            "telephone_number": "937-589-2277"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "303 Meadowlake Rd",
            "address_purpose": "LOCATION",
            "city": "Yorktown",
            "state": "VA",
            "postal_code": "236933617",
            "country_code": "US",
            "telephone_number": "757-713-0385",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KING",
        "first_name": "ANTONIO",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LSATP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-25",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VA",
            "license": "0718000615",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VA",
            "license": "0710103027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kindred Hospitals East, LLC (Kindred Hospital - Dayton)
• Kindred Hospitals East, LLC (Kindred Hospital - Dayton (Behavioral Health Unit))
• King Tree Leasing Co., LLC (Riverside Healthcare Center)
• Andrea L King, LSW
• Andrea Lynn King, PA-C
• Beverly R King, O.T.
• Brianna Marie King, MS, RDN, LD
• Carla Renee King, CNM
• Casey Lanette King
• Casondra Marie King, RN

• Addiction (Substance Use Disorder) Counselor in Dayton, OH
• Providers in Dayton, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.