King Prestige Services LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

KING PRESTIGE SERVICES LLC

Practice address

294 Church St N
Concord, NC 28025-4571

Phone

(980) 258-9316

Fax

(704) 960-4520

NPI assigned

Feb 22, 2021

Last updated

Mar 26, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Carlisa Booker

Title

Owner

Phone

(980) 258-9316

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Interoperability endpoints

• Direct secure messaging: cb@kingprestigeservices.org

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tasha Burnette, LPC

  • Professional Counselor
  • Greensboro, NC
  • NPI 1659776151
  Medicare reassignment NPD
• Tiarra M Myers, MSW

  • Clinical Social Worker
  • Fort Bragg, NC
  • NPI 1881009173
  Medicare reassignment NPD
• Marion Keith Hart, MSW, LCSW

  • Clinical Social Worker
  • Salisbury, NC
  • NPI 1417919697
  Medicare reassignment

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

{
    "created_epoch": "1613952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711411200000",
    "number": "1710571617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "294 CHURCH ST N",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280254571",
            "telephone_number": "980-258-9316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "294 CHURCH ST N",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280254571",
            "telephone_number": "980-258-9316",
            "fax_number": "704-960-4520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KING PRESTIGE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-22",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-11",
        "status": "A",
        "authorized_official_last_name": "BOOKER",
        "authorized_official_first_name": "CARLISA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "980-258-9316",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cb@kingprestigeservices.org",
            "affiliation": "N",
            "endpointDescription": "cb@kingprestigeservices.org",
            "address_1": "3 Union St S Ste 230",
            "city": "Concord",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280255288",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cb@kingprestigeservices.org",
            "affiliation": "N",
            "endpointDescription": "cb@kingprestigeservices.org",
            "address_1": "3 Union St S Ste 240",
            "city": "Concord",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280255288",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sarah Liebman Kilmer, PHD
• Tracy M Kilmurry, OTR L
• Gloria Denice Kimble, MSW
• Hollie Easterling Kimbrough, LCASA
• Mandy Propst Kinard
• Alicia King
• Asiel King
• Michaela Christin King, LPCA
• Peter Brent King, D.O.
• Sarah Grace King, SLP

• Community/Behavioral Health Agency in Concord, NC
• Providers in Concord, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; 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.