Provider Demographics
NPI:1770655227
Name:SLATON, BILLY J (LPC, PHD)
Entity Type:Individual
Prefix:
First Name:BILLY
Middle Name:J
Last Name:SLATON
Suffix:
Gender:M
Credentials:LPC, PHD
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 964
Mailing Address - Street 2:
Mailing Address - City:CLARKESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30523-0017
Mailing Address - Country:US
Mailing Address - Phone:706-768-1420
Mailing Address - Fax:706-754-4435
Practice Address - Street 1:695 WASHINGTON ST.
Practice Address - Street 2:
Practice Address - City:CLARKESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30523
Practice Address - Country:US
Practice Address - Phone:706-768-1420
Practice Address - Fax:706-754-4435
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC001459101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor