Provider Demographics
NPI:1902257074
Name:KING, ARLYN COOK (LCSW)
Entity Type:Individual
Prefix:
First Name:ARLYN
Middle Name:COOK
Last Name:KING
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19815 BAY BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:ANDALUSIA
Mailing Address - State:AL
Mailing Address - Zip Code:36420-9234
Mailing Address - Country:US
Mailing Address - Phone:334-222-2525
Mailing Address - Fax:334-222-4660
Practice Address - Street 1:19815 BAY BRANCH RD
Practice Address - Street 2:
Practice Address - City:ANDALUSIA
Practice Address - State:AL
Practice Address - Zip Code:36420-9234
Practice Address - Country:US
Practice Address - Phone:334-222-2525
Practice Address - Fax:334-222-4660
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-29
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3887C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical