Provider Demographics
NPI:1487016085
Name:SLACUM, CHELSEA COHEE (LCSW-C)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:COHEE
Last Name:SLACUM
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5437 WHITEHALL RD
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21613-3441
Mailing Address - Country:US
Mailing Address - Phone:410-829-4100
Mailing Address - Fax:
Practice Address - Street 1:125 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-3279
Practice Address - Country:US
Practice Address - Phone:410-829-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-22
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18273104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD609550002Medicaid