Provider Demographics
NPI:1003961806
Name:SLAUGHTER, LAURA (LCSW, CADC)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:
Last Name:SLAUGHTER
Suffix:
Gender:F
Credentials:LCSW, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2365 HARRODSBURG RD STE B225
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-3377
Mailing Address - Country:US
Mailing Address - Phone:859-229-5839
Mailing Address - Fax:859-276-0707
Practice Address - Street 1:2365 HARRODSBURG RD STE B225
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504
Practice Address - Country:US
Practice Address - Phone:859-229-5839
Practice Address - Fax:859-276-0707
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1021101YA0400X
KY30311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY30615058Medicaid
KY30615058Medicaid