Provider Demographics
NPI:1902210974
Name:FLOBERG, SLOANE (LPC)
Entity Type:Individual
Prefix:
First Name:SLOANE
Middle Name:
Last Name:FLOBERG
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1702 E MAIN ST STE 101
Mailing Address - Street 2:
Mailing Address - City:MANDAN
Mailing Address - State:ND
Mailing Address - Zip Code:58554-3818
Mailing Address - Country:US
Mailing Address - Phone:701-751-8060
Mailing Address - Fax:701-751-8060
Practice Address - Street 1:1702 E MAIN ST STE 101
Practice Address - Street 2:
Practice Address - City:MANDAN
Practice Address - State:ND
Practice Address - Zip Code:58554-3818
Practice Address - Country:US
Practice Address - Phone:701-751-8060
Practice Address - Fax:701-751-8060
Is Sole Proprietor?:No
Enumeration Date:2014-06-17
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND766111513101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND145802Medicaid