Provider Demographics
NPI:1558647917
Name:SLABAUGH, LANITA LYNN (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:LANITA
Middle Name:LYNN
Last Name:SLABAUGH
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MRS
Other - First Name:LANNIE
Other - Middle Name:
Other - Last Name:SLABAUGH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:1385 S WILLIAMSTON RD
Mailing Address - Street 2:
Mailing Address - City:DANSVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48819-9787
Mailing Address - Country:US
Mailing Address - Phone:517-525-6432
Mailing Address - Fax:
Practice Address - Street 1:2172 COMMONS PKWY STE C
Practice Address - Street 2:
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-3986
Practice Address - Country:US
Practice Address - Phone:517-292-3534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-31
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010860941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical