Provider Demographics
NPI:1992072664
Name:KING, PAUL JOSEPH (LMHC)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:JOSEPH
Last Name:KING
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 STORTINI DR
Mailing Address - Street 2:
Mailing Address - City:RHINEBECK
Mailing Address - State:NY
Mailing Address - Zip Code:12572-1858
Mailing Address - Country:US
Mailing Address - Phone:845-876-6003
Mailing Address - Fax:845-876-1650
Practice Address - Street 1:10 STORTINI DR
Practice Address - Street 2:
Practice Address - City:RHINEBECK
Practice Address - State:NY
Practice Address - Zip Code:12572-1858
Practice Address - Country:US
Practice Address - Phone:845-876-6003
Practice Address - Fax:845-876-1650
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-24
Last Update Date:2011-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY18-004908101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health