Jason Charles King, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071007455 Issued in IL

Practice address

1599 Maple Ave
Evanston, IL 60201-4367

Phone

(708) 699-1670

Fax

(847) 570-6083

NPI assigned

May 5, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1209945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219017600000",
    "number": "1760658314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1137 MAPLE AVE",
            "address_2": "2E",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602021262",
            "telephone_number": "708-699-1670",
            "fax_number": "847-570-6083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1599 MAPLE AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014367",
            "telephone_number": "708-699-1670",
            "fax_number": "847-570-6083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "JASON",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-05",
        "last_updated": "2008-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071007455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Kinderman
• Kindroot Counseling, PLLC
• Carter Kindschy, PA-C
• Dana King, LCPC
• Emily Lynn King, DPT
• Mary Margaret King, PA
• Kingdom Reliable Transport LLC
• Chad Patrick Kingsbury, LCSW
• Hanna Marie Kingstad
• Bailey Kingston

• Clinical Psychologist in Evanston, IL
• Providers in Evanston, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2008; 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.