Individual
MR. EDWARD CORNELIUS KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
4131 SPICEWOOD SPRINGS RD, SUITE Q-2, AUSTIN, TX 78759-8661
(512) 338-4095
(512) 338-4070
Mailing address
4131 SPICEWOOD SPRINGS RD, SUITE Q-2, AUSTIN, TX 78759-8661
(512) 338-4095
(512) 338-4070
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
06628
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00S83J
BLUE CROSS BLUE SHIELD
TX
01
—
227440000
MAGELLAN BEHAVIORAL HEALT
TX
Enumeration date
02/28/2007
Last updated
01/03/2012
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