Provider Demographics
NPI:1073942587
Name:SLAYTON FLEMING, DARIAN LEA (LCSW, CRC)
Entity Type:Individual
Prefix:
First Name:DARIAN
Middle Name:LEA
Last Name:SLAYTON FLEMING
Suffix:
Gender:F
Credentials:LCSW, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12616 NE PRESCOTT DR
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97230-1212
Mailing Address - Country:US
Mailing Address - Phone:503-522-3272
Mailing Address - Fax:503-961-8180
Practice Address - Street 1:10424 SE CHERRY BLOSSOM DR
Practice Address - Street 2:SUITE B1
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97216-2801
Practice Address - Country:US
Practice Address - Phone:503-522-3272
Practice Address - Fax:503-961-8180
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-05
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR00068870101Y00000X
OR159251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor