Provider Demographics
NPI:1114781978
Name:SLOAN, DANA MICHELLE (MA, LPC)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:MICHELLE
Last Name:SLOAN
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 SOUTHRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CANYON
Mailing Address - State:TX
Mailing Address - Zip Code:79015-2003
Mailing Address - Country:US
Mailing Address - Phone:806-420-0709
Mailing Address - Fax:806-351-7155
Practice Address - Street 1:121 WESTGATE PKWY STE 40
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79121-1113
Practice Address - Country:US
Practice Address - Phone:806-351-7150
Practice Address - Fax:806-351-7155
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX86528101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health