Provider Demographics
NPI:1659557445
Name:SLUTZKY, BRIAN STEPHEN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:STEPHEN
Last Name:SLUTZKY
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2283 WRIGHTSBORO RD
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30904-4717
Mailing Address - Country:US
Mailing Address - Phone:706-922-3252
Mailing Address - Fax:706-922-3253
Practice Address - Street 1:2283 WRIGHTSBORO RD
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30904-4717
Practice Address - Country:US
Practice Address - Phone:706-922-3252
Practice Address - Fax:706-922-3253
Is Sole Proprietor?:No
Enumeration Date:2008-01-11
Last Update Date:2024-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY5134103TC0700X
GAPSY003249103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL211205100Medicaid
FL211205100Medicaid