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NPI Code Detail

MEDICARE: CODI SLATER MS, LMHCA

MEDICARE: CODI SLATER MS, LMHCA
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
1101Y00000XCounselorCG61032274WA
2101YM0800XMental Health CounselorMC70122874WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1770123085
Entity Type Code : Individual
Provider Name (Legal Business Name) : CODI SLATER MS, LMHCA
Provider Business Mailing Address
First Line : PO BOX 2394
Second Line :
City : LONGVIEW
State : WA
Zip : 98632-8455
Country : US
Telephone Number : 360-200-5419
Fax Number : 844-612-6673
Provider Business Practice Location Address
First Line : 1400 COMMERCE AVE
Second Line :
City : LONGVIEW
State : WA
Zip : 98632-3756
Country : US
Telephone Number : 360-998-2047
Fax Number : 360-200-6736
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/14/2020
Last Update Date : 04/17/2026

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