Individual
JUSTIN T. KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
463 LENA LN, FRUITLAND, MD 21826-2034
(410) 845-1092
Mailing address
463 LENA LN, FRUITLAND, MD 21826-2034
(410) 845-1092
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LC14056
MD
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
705371101
—
MD
Enumeration date
03/19/2007
Last updated
02/10/2025
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