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NPI Code Detail

MEDICARE: RENEA SLAUGHTER LCSW

MEDICARE: RENEA SLAUGHTER LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerLC200001507DC
21041C0700XClinical Social Worker28095MD
31041C0700XClinical Social Worker0904011327VA
41041C0700XClinical Social WorkerC008747NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10904011327OTHERVALICENSE
228095OTHERMDLICENSE
3C008747OTHERNCLICENSE
4LC200001507OTHERDCLICENSE

General Provider Information

NPI Number : 1013307933
Entity Type Code : Individual
Provider Name (Legal Business Name) : RENEA SLAUGHTER LCSW
Provider Business Mailing Address
First Line : 2957 FESTIVAL WAY STE 123
Second Line :
City : WALDORF
State : MD
Zip : 20601-2959
Country : US
Telephone Number : 803-422-4892
Fax Number :
Provider Business Practice Location Address
First Line : 5000 THAYER CTR STE C
Second Line :
City : OAKLAND
State : MD
Zip : 21550-1139
Country : US
Telephone Number : 703-718-6811
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2015
Last Update Date : 11/08/2023

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Directions to “ RENEA SLAUGHTER LCSW” Practice Location

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