Individual
ELIZABETH M KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
87001637A
IN
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
34008413A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000001304251
ANTHEM PTAN
IN
01
—
1102362800
ANTHEM PTAN
IN
05
—
300046536
—
IN
Enumeration date
05/04/2016
Last updated
02/12/2025
Update your record
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