Provider Demographics
NPI:1306199088
Name:SLYWKA, JOHN (LMFT, LPC)
Entity Type:Individual
Prefix:PROF
First Name:JOHN
Middle Name:
Last Name:SLYWKA
Suffix:
Gender:M
Credentials:LMFT, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 W CAMPBELL RD
Mailing Address - Street 2:SUITE ONE
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-3357
Mailing Address - Country:US
Mailing Address - Phone:972-437-1400
Mailing Address - Fax:
Practice Address - Street 1:600 W CAMPBELL RD
Practice Address - Street 2:SUITE ONE
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3357
Practice Address - Country:US
Practice Address - Phone:972-437-1400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-18
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12886101YP2500X
TX4602106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional