Healthcare Provider Details

I. General information

NPI: 1437998770
Provider Name (Legal Business Name): SLATER WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2024
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 N HIGHWAY A1A STE A104
JUPITER FL
33477-4561
US

IV. Provider business mailing address

177 VIA CONDADO WAY
PALM BEACH GARDENS FL
33418-1703
US

V. Phone/Fax

Practice location:
  • Phone: 404-408-7256
  • Fax:
Mailing address:
  • Phone: 404-408-7256
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: CYNTHIA V SLATER
Title or Position: CEO
Credential: LCSW
Phone: 404-408-7256