MEDICARE: JENNIFER MICHELE SLATTERY LPC

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	101YP2500X	Professional Counselor	0701015678	VA

General Provider Information

NPI Number	:	1538022363
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER MICHELE SLATTERY LPC

Provider Business Mailing Address
First Line	:	6862 ELM ST STE 820
Second Line	:
City	:	MC LEAN
State	:	VA
Zip	:	22101-3868
Country	:	US
Telephone Number	:	703-261-4583
Fax Number	:

Provider Business Practice Location Address
First Line	:	6862 ELM ST STE 820
Second Line	:
City	:	MC LEAN
State	:	VA
Zip	:	22101-3868
Country	:	US
Telephone Number	:	703-261-4583
Fax Number	:

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

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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