Basic Information
| Provider Information | |||||||||
| NPI: | 1871016113 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KING | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | |||||||||
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| Credential: | MA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 68 FRANKLIN ST | ||||||||
| Address2: | |||||||||
| City: | FRAMINGHAM | ||||||||
| State: | MA | ||||||||
| PostalCode: | 017026671 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5088755801 | ||||||||
| FaxNumber: | 5088728934 | ||||||||
| Practice Location | |||||||||
| Address1: | 68 FRANKLIN ST | ||||||||
| Address2: | |||||||||
| City: | FRAMINGHAM | ||||||||
| State: | MA | ||||||||
| PostalCode: | 017026671 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5088755801 | ||||||||
| FaxNumber: | 5088728934 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/19/2017 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.