Provider Demographics
NPI:1396443750
Name:KING, DESTINY A (BCBA, LBA)
Entity type:Individual
Prefix:
First Name:DESTINY
Middle Name:A
Last Name:KING
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 DANA CT
Mailing Address - Street 2:
Mailing Address - City:GLASGOW
Mailing Address - State:KY
Mailing Address - Zip Code:42141-8753
Mailing Address - Country:US
Mailing Address - Phone:270-535-8593
Mailing Address - Fax:
Practice Address - Street 1:820 DANA CT
Practice Address - Street 2:
Practice Address - City:GLASGOW
Practice Address - State:KY
Practice Address - Zip Code:42141-8753
Practice Address - Country:US
Practice Address - Phone:270-535-8593
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-15
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC308103K00000X
KY283881103K00000X
KY1-23-64172103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
1396443750OtherUNITED BEHAVIORAL HEALTH/US BEHAVIORAL HEALTH PLAN, CALIFORNIA/LIFEERA, INC.
1396443750OtherAETNA
1396443750OtherWELLCARE/CARE1ST
KY1396443750OtherCARELON BEHAVIORAL HEALTH, INC
1396443750OtherHUMANA/CHOICECARE
1396443750OtherMULTIPLAN, INCORPORATED
1396443750OtherMOLINA HEALTHCARE, INC.
KY1396443750OtherAETNA BETTER HEALTH
1396443750OtherCENTER CARE HEALTH BENEFIT PROGRAMS
KY7100881450Medicaid
1396443750OtherEMPIRE BLUE CROSS BLUE SHIELD/CAREMORE/WELLPOINT MILITARY CARE,AMERIGROUP CORPOR