Provider Demographics
NPI:1215635073
Name:KING, JESSALYNN (LMSW)
Entity type:Individual
Prefix:
First Name:JESSALYNN
Middle Name:
Last Name:KING
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:691 JOHN WESLEY DOBBS AVE NE STE V-232
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30312-1690
Mailing Address - Country:US
Mailing Address - Phone:404-394-5272
Mailing Address - Fax:
Practice Address - Street 1:691 JOHN WESLEY DOBBS AVE NE STE V-232
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312-1690
Practice Address - Country:US
Practice Address - Phone:404-394-5272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-21
Last Update Date:2025-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW012536104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker