Provider Demographics
NPI:1104212521
Name:SLATON, JAMES K (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:K
Last Name:SLATON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:54 HIDDEN VALLEY EST
Mailing Address - Street 2:
Mailing Address - City:GLASGOW
Mailing Address - State:KY
Mailing Address - Zip Code:42141-7887
Mailing Address - Country:US
Mailing Address - Phone:270-361-1300
Mailing Address - Fax:
Practice Address - Street 1:1497 NASHVILLE ST
Practice Address - Street 2:
Practice Address - City:RUSSELLVILLE
Practice Address - State:KY
Practice Address - Zip Code:42276-8850
Practice Address - Country:US
Practice Address - Phone:270-726-9568
Practice Address - Fax:270-726-9570
Is Sole Proprietor?:No
Enumeration Date:2015-04-13
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY40201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100347310Medicaid