Provider Demographics
NPI:1073703039
Name:SLATUS, JESSICA K (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:K
Last Name:SLATUS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:395 16TH ST
Mailing Address - Street 2:1
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-5607
Mailing Address - Country:US
Mailing Address - Phone:646-621-3235
Mailing Address - Fax:
Practice Address - Street 1:333 AVENUE X
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-5947
Practice Address - Country:US
Practice Address - Phone:718-339-5300
Practice Address - Fax:718-339-9082
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-26
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker