Provider Demographics
NPI:1154462877
Name:SLOCHOWER, MITCHELL (LCSW)
Entity Type:Individual
Prefix:MR
First Name:MITCHELL
Middle Name:
Last Name:SLOCHOWER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 WOODSTOCK PL
Mailing Address - Street 2:
Mailing Address - City:LAKE GROVE
Mailing Address - State:NY
Mailing Address - Zip Code:11755-2836
Mailing Address - Country:US
Mailing Address - Phone:631-467-5591
Mailing Address - Fax:631-467-5591
Practice Address - Street 1:14 WOODSTOCK PL
Practice Address - Street 2:
Practice Address - City:LAKE GROVE
Practice Address - State:NY
Practice Address - Zip Code:11755-2836
Practice Address - Country:US
Practice Address - Phone:631-467-5591
Practice Address - Fax:631-467-5591
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYLCSW 035574101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health