Provider Demographics
NPI:1326025131
Name:KING, TERESA DENISE (PSYD)
Entity type:Individual
Prefix:DR
First Name:TERESA
Middle Name:DENISE
Last Name:KING
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:TERESA
Other - Middle Name:DENISE
Other - Last Name:ROSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:6107 HELLEN LEE DR
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-3430
Mailing Address - Country:US
Mailing Address - Phone:202-534-2966
Mailing Address - Fax:
Practice Address - Street 1:CSOSA / RE-ENTRY & SANCTIONS CENTER
Practice Address - Street 2:1900 MASSACHUSETTS AVENUE, BLDG. 17
Practice Address - City:WASHINGTON DC
Practice Address - State:DC
Practice Address - Zip Code:20003
Practice Address - Country:US
Practice Address - Phone:202-345-6949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2026103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical