MEDICARE: MICHAEL SLIK LMHC

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	101YM0800X	Mental Health Counselor	003726	NY

General Provider Information

NPI Number	:	1376931725
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL SLIK LMHC

Provider Business Mailing Address
First Line	:	540 DELAWARE AVE
Second Line	:
City	:	ALBANY
State	:	NY
Zip	:	12209-1415
Country	:	US
Telephone Number	:	518-369-1448
Fax Number	:

Provider Business Practice Location Address
First Line	:	540 DELAWARE AVE
Second Line	:
City	:	ALBANY
State	:	NY
Zip	:	12209-1415
Country	:	US
Telephone Number	:	518-369-1448
Fax Number	:

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

Provider Enumeration Date	:	01/07/2015
Last Update Date	:	10/21/2020

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