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General NPI Number Information
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NPI Number | 1023965548
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Entity Type | Individual
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Provider Name | JARRELL SLADE LCPC
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Gender | Male
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Dates
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Enumeration Date | 03/13/2026
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Last Update Date | 03/13/2026
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Provider Practice Location Address
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Address Line | 3600 CLIPPER MILL RD STE 221
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City | BALTIMORE
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State | MD
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Zip | 21211-1946
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Country | US
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Telephone | 443-320-2313
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Fax |
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Provider Business Mailing Address
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Address Line | 3705 33RD ST APT 3C
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City | MOUNT RAINIER
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State | MD
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Zip | 20712-2082
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Country | US
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Telephone | 301-385-8872
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LC17550
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License Number State | MD
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