Provider Demographics
NPI:1053960823
Name:KING, SHAYLIN FAITH
Entity type:Individual
Prefix:
First Name:SHAYLIN
Middle Name:FAITH
Last Name:KING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:955 W WADE HAMPTON BLVD STE 4A
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29650-1296
Mailing Address - Country:US
Mailing Address - Phone:864-936-1943
Mailing Address - Fax:
Practice Address - Street 1:955 W WADE HAMPTON BLVD STE 4A
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29650-1296
Practice Address - Country:US
Practice Address - Phone:864-936-1943
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-05
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7911106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist