Provider Demographics
NPI:1326204926
Name:SLAGLE, ANDREA MICHELE (LSCSW)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:MICHELE
Last Name:SLAGLE
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4233 SW EMLAND DR
Mailing Address - Street 2:#8
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66606-2181
Mailing Address - Country:US
Mailing Address - Phone:785-230-7319
Mailing Address - Fax:
Practice Address - Street 1:3320 SW HARRISON ST
Practice Address - Street 2:SUITE 9
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66611-2253
Practice Address - Country:US
Practice Address - Phone:785-230-2467
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-03
Last Update Date:2012-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS40691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical