Provider Demographics
NPI:1669676359
Name:SLAUGHTER, ALICE THOMPSON (ASW)
Entity Type:Individual
Prefix:MRS
First Name:ALICE
Middle Name:THOMPSON
Last Name:SLAUGHTER
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 MYRTLE ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94607-2525
Mailing Address - Country:US
Mailing Address - Phone:510-759-7677
Mailing Address - Fax:
Practice Address - Street 1:111 MYRTLE ST
Practice Address - Street 2:SUITE 102
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94607-2525
Practice Address - Country:US
Practice Address - Phone:510-759-7677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALES123491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical