Provider Demographics
NPI:1447756788
Name:SLAUGHTER, AQUANTONETTE (LPC)
Entity Type:Individual
Prefix:MS
First Name:AQUANTONETTE
Middle Name:
Last Name:SLAUGHTER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 S JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60661-5603
Mailing Address - Country:US
Mailing Address - Phone:312-441-9009
Mailing Address - Fax:312-441-9019
Practice Address - Street 1:1140 W 79TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60620-3029
Practice Address - Country:US
Practice Address - Phone:773-962-2683
Practice Address - Fax:773-962-2699
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-04
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.010081101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health