Provider Demographics
NPI:1346566247
Name:GORDON-SLAKOFF, JANET (LCSW)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:GORDON-SLAKOFF
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JAN
Other - Middle Name:
Other - Last Name:GORDON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:6161 NW 80TH TER
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33067-1132
Mailing Address - Country:US
Mailing Address - Phone:954-383-4804
Mailing Address - Fax:510-880-7627
Practice Address - Street 1:6161 NW 80TH TER
Practice Address - Street 2:
Practice Address - City:PARKLAND
Practice Address - State:FL
Practice Address - Zip Code:33067-1132
Practice Address - Country:US
Practice Address - Phone:954-383-4804
Practice Address - Fax:510-880-7627
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-16
Last Update Date:2010-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW23481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical