MEDICARE: WILLIAM STEPHEN SLAVIN LLP LMSW

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
1	103T00000X	Psychologist	6301003757	MI
2	104100000X	Social Worker	6801014929	MI

General Provider Information

NPI Number	:	1154409373
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM STEPHEN SLAVIN LLP LMSW

Provider Business Mailing Address
First Line	:	105 HALL ST
Second Line	:	SUITE A
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49684-2288
Country	:	US
Telephone Number	:	231-922-4850
Fax Number	:	231-935-3856

Provider Business Practice Location Address
First Line	:	105 HALL ST
Second Line	:	SUITE A
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49684-2288
Country	:	US
Telephone Number	:	231-922-4850
Fax Number	:	231-935-3856

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2006
Last Update Date	:	09/11/2025

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