Provider Demographics
NPI:1710297767
Name:SLATON, SAM R II (LPC-S)
Entity Type:Individual
Prefix:MR
First Name:SAM
Middle Name:R
Last Name:SLATON
Suffix:II
Gender:M
Credentials:LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:914 COUNTRY CLUB RD
Mailing Address - Street 2:
Mailing Address - City:ARGYLE
Mailing Address - State:TX
Mailing Address - Zip Code:76226-2503
Mailing Address - Country:US
Mailing Address - Phone:800-258-4250
Mailing Address - Fax:940-464-0323
Practice Address - Street 1:914 COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:ARGYLE
Practice Address - State:TX
Practice Address - Zip Code:76226-2503
Practice Address - Country:US
Practice Address - Phone:940-464-7222
Practice Address - Fax:940-464-0323
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-08
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61133101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor