Provider Demographics
NPI:1588205835
Name:SLATER, NATASHA (LMSW, ASW)
Entity type:Individual
Prefix:
First Name:NATASHA
Middle Name:
Last Name:SLATER
Suffix:
Gender:F
Credentials:LMSW, ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 25093
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11202-5093
Mailing Address - Country:US
Mailing Address - Phone:646-617-7860
Mailing Address - Fax:
Practice Address - Street 1:2381 HYLAN BLVD STE 13
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10306-3145
Practice Address - Country:US
Practice Address - Phone:718-494-2858
Practice Address - Fax:718-494-5749
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-07
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY106778-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker