Provider Demographics
NPI:1376073452
Name:SLABAUGH, MICHELE (DBH, LPC/MHSP, NCC)
Entity Type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:
Last Name:SLABAUGH
Suffix:
Gender:F
Credentials:DBH, LPC/MHSP, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2241 MONTHEMER CV
Mailing Address - Street 2:
Mailing Address - City:MT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-7459
Mailing Address - Country:US
Mailing Address - Phone:215-804-8306
Mailing Address - Fax:
Practice Address - Street 1:275 CUMBERLAND BND
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37228-1805
Practice Address - Country:US
Practice Address - Phone:866-816-0433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-12
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC009653101YP2500X
TN5738101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional