Provider Demographics
NPI:1275857716
Name:SLATER, CARLOTTA M (LPC CADC)
Entity Type:Individual
Prefix:MRS
First Name:CARLOTTA
Middle Name:M
Last Name:SLATER
Suffix:
Gender:F
Credentials:LPC CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13854 LAKESIDE CIR STE 245
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48313-1316
Mailing Address - Country:US
Mailing Address - Phone:586-580-4243
Mailing Address - Fax:
Practice Address - Street 1:13854 LAKESIDE CIR STE 245
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48313-1316
Practice Address - Country:US
Practice Address - Phone:586-580-4243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-25
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401011148101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI382230613OtherFIN#