Healthcare Provider Details

I. General information

NPI: 1447497367
Provider Name (Legal Business Name): JEFFREY SLAUGHTER LSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/14/2009
Last Update Date: 01/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4760 MADISON RD
CINCINNATI OH
45227-1426
US

IV. Provider business mailing address

2600 VICTORY PKWY
CINCINNATI OH
45206-1711
US

V. Phone/Fax

Practice location:
  • Phone: 513-321-8286
  • Fax: 513-533-5834
Mailing address:
  • Phone: 513-751-7747
  • Fax: 513-872-5182

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: