Provider Demographics
NPI:1972176808
Name:ANDERSEN KING, CELINA RAYE (LCSW)
Entity type:Individual
Prefix:
First Name:CELINA
Middle Name:RAYE
Last Name:ANDERSEN KING
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 686
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:TX
Mailing Address - Zip Code:78124-0686
Mailing Address - Country:US
Mailing Address - Phone:830-914-5011
Mailing Address - Fax:
Practice Address - Street 1:388 STALLION LN
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:TX
Practice Address - Zip Code:78124-3014
Practice Address - Country:US
Practice Address - Phone:830-914-5011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-19
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX559351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical