Provider Demographics
NPI:1275097974
Name:SLATER, CLAIRE E (ATR, LCPC)
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:E
Last Name:SLATER
Suffix:
Gender:F
Credentials:ATR, LCPC
Other - Prefix:
Other - First Name:CLAIRE
Other - Middle Name:E
Other - Last Name:SZABADOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATR, LCPC
Mailing Address - Street 1:3101 N MONTICELLO AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-6681
Mailing Address - Country:US
Mailing Address - Phone:216-280-4675
Mailing Address - Fax:
Practice Address - Street 1:3101 N MONTICELLO AVE APT 2
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-6681
Practice Address - Country:US
Practice Address - Phone:216-280-4675
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-27
Last Update Date:2019-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.011530101YM0800X
IL17-429221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist