Healthcare Provider Details

I. General information

NPI: 1740741958
Provider Name (Legal Business Name): KIMBERLY LYNN SLAUGHTER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2019
Last Update Date: 03/22/2024
Certification Date: 03/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 W LONG ST
COLUMBUS OH
43215-2817
US

IV. Provider business mailing address

10529 N SHORE DR
HILLSBORO OH
45133-9202
US

V. Phone/Fax

Practice location:
  • Phone: 614-224-1131
  • Fax:
Mailing address:
  • Phone: 717-578-9039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberC.2103119
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.2103119
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: