Provider Demographics
NPI:1871142521
Name:KING, CAYLEE (LPCA, LCMHCA, NCC)
Entity type:Individual
Prefix:
First Name:CAYLEE
Middle Name:
Last Name:KING
Suffix:
Gender:F
Credentials:LPCA, LCMHCA, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1913 SKIPPING STONE DR
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29715-7622
Mailing Address - Country:US
Mailing Address - Phone:817-437-7687
Mailing Address - Fax:
Practice Address - Street 1:1913 SKIPPING STONE DR
Practice Address - Street 2:
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29715-7622
Practice Address - Country:US
Practice Address - Phone:817-437-7687
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-05
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7160101YP2500X
NCA14942101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty