=====================================================
General NPI Number Information
=====================================================
NPI Number | 1063268613
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALESSANDRA SLAVIN LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/25/2024
-----------------------------------------------------
Last Update Date | 04/25/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2919 OLNEY SANDY SPRING RD STE C
-----------------------------------------------------
City | OLNEY
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20832-1588
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-613-5416
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 18608 THORNBERRY LN
-----------------------------------------------------
City | OLNEY
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20832-1819
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-613-5416
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | ALESSANDRA SLAVIN
-----------------------------------------------------
Credential | LCSWC
-----------------------------------------------------
Telephone | 301-613-5416
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------