Provider Demographics
NPI:1114750825
Name:KING, TERRENCE R (VA VICTIM ADVOCATE)
Entity type:Individual
Prefix:
First Name:TERRENCE
Middle Name:R
Last Name:KING
Suffix:
Gender:M
Credentials:VA VICTIM ADVOCATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 MOUNTAIN SPRINGS CV
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:GA
Mailing Address - Zip Code:30157-1217
Mailing Address - Country:US
Mailing Address - Phone:888-635-1022
Mailing Address - Fax:833-367-0119
Practice Address - Street 1:31 MOUNTAIN SPRINGS CV
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:GA
Practice Address - Zip Code:30157-1217
Practice Address - Country:US
Practice Address - Phone:888-635-1022
Practice Address - Fax:833-390-1531
Is Sole Proprietor?:No
Enumeration Date:2024-08-20
Last Update Date:2025-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA3747A0650X, 172V00000X, 171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No172V00000XOther Service ProvidersCommunity Health Worker