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NPI Code Detail

MEDICARE: MRS. SHANNON V SLAUSON M.A., LMFT

MEDICARE: MRS. SHANNON V SLAUSON M.A., LMFT
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
1106H00000XMarriage & Family Therapist

General Provider Information

NPI Number : 1417339060
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SHANNON V SLAUSON M.A., LMFT
Provider Business Mailing Address
First Line : 9719 NORTHEAST PKWY STE 100
Second Line :
City : MATTHEWS
State : NC
Zip : 28105-9713
Country : US
Telephone Number : 980-217-3986
Fax Number :
Provider Business Practice Location Address
First Line : 9719 NORTHEAST PKWY STE 100
Second Line :
City : MATTHEWS
State : NC
Zip : 28105-9713
Country : US
Telephone Number : 980-217-3986
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2015
Last Update Date : 09/19/2023

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