Provider Demographics
NPI:1760492474
Name:KING-CAGLE, MARGARET ALLYSON (LCSW)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:ALLYSON
Last Name:KING-CAGLE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:ALLYSON
Other - Last Name:CAGLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:8512 E PARKWAY S
Mailing Address - Street 2:
Mailing Address - City:LAUDERDALE
Mailing Address - State:MS
Mailing Address - Zip Code:39335-9567
Mailing Address - Country:US
Mailing Address - Phone:601-632-1246
Mailing Address - Fax:
Practice Address - Street 1:248 E CAPITOL ST
Practice Address - Street 2:840 TRUST MARK BLDG
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39201-2503
Practice Address - Country:US
Practice Address - Phone:800-632-6074
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSC1356101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health