Healthcare Provider Details

I. General information

NPI: 1275097974
Provider Name (Legal Business Name): CLAIRE E SLATER ATR, LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CLAIRE E SZABADOS ATR, LCPC

II. Dates (important events)

Enumeration Date: 01/27/2019
Last Update Date: 01/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3101 N MONTICELLO AVE APT 2
CHICAGO IL
60618-6681
US

IV. Provider business mailing address

3101 N MONTICELLO AVE APT 2
CHICAGO IL
60618-6681
US

V. Phone/Fax

Practice location:
  • Phone: 216-280-4675
  • Fax:
Mailing address:
  • Phone: 216-280-4675
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number180.011530
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number17-429
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: