Provider Demographics
NPI:1881587236
Name:KING, KENNETH HENRY (SOCIAL WORKER)
Entity type:Individual
Prefix:
First Name:KENNETH
Middle Name:HENRY
Last Name:KING
Suffix:
Gender:M
Credentials:SOCIAL WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3804 SUITLAND RD SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-1200
Mailing Address - Country:US
Mailing Address - Phone:202-302-0275
Mailing Address - Fax:202-302-0275
Practice Address - Street 1:3804 SUITLAND RD SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-1200
Practice Address - Country:US
Practice Address - Phone:202-302-0275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC3023891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty