Healthcare Provider Details

I. General information

NPI: 1497445571
Provider Name (Legal Business Name): NATHAN SLAUGHTER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2023
Last Update Date: 05/11/2023
Certification Date: 05/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 SPRING ST # 300
SILVER SPRING MD
20910-2701
US

IV. Provider business mailing address

1501 1ST ST NW UNIT 1
WASHINGTON DC
20001-5038
US

V. Phone/Fax

Practice location:
  • Phone: 240-847-7507
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: