Provider Demographics
NPI:1780253294
Name:KING, JEFFREY BARTON (MA, LPC)
Entity type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:BARTON
Last Name:KING
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6504 COLLARD CT
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76182-4224
Mailing Address - Country:US
Mailing Address - Phone:181-731-2334
Mailing Address - Fax:
Practice Address - Street 1:6504 COLLARD CT
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76182-4224
Practice Address - Country:US
Practice Address - Phone:817-312-3349
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-19
Last Update Date:2021-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX82907101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty