Provider Demographics
NPI:1528755956
Name:KING, NANCY PRINCE (LCPC-C)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:PRINCE
Last Name:KING
Suffix:
Gender:F
Credentials:LCPC-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 CLAY COVE RD
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-7940
Mailing Address - Country:US
Mailing Address - Phone:207-619-4278
Mailing Address - Fax:
Practice Address - Street 1:16 UNION ST
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-1918
Practice Address - Country:US
Practice Address - Phone:207-619-4278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-18
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEXL6963101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health