Healthcare Provider Details

I. General information

NPI: 1790609022
Provider Name (Legal Business Name): MARIA SLONE CSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 BOSTON SQ
GEORGETOWN KY
40324-9786
US

IV. Provider business mailing address

128 MEADOWLARK DR APT 12
RICHMOND KY
40475-2255
US

V. Phone/Fax

Practice location:
  • Phone: 502-642-8046
  • Fax:
Mailing address:
  • Phone: 606-276-9393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number255259
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: