Provider Demographics
NPI:1992840656
Name:JERE' L. SLINGERLAND, LCSW.INC
Entity Type:Organization
Organization Name:JERE' L. SLINGERLAND, LCSW.INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JERE'
Authorized Official - Middle Name:L
Authorized Official - Last Name:SLINGERLAND
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:253-638-8730
Mailing Address - Street 1:536 BUTTE AVE
Mailing Address - Street 2:
Mailing Address - City:PACIFIC
Mailing Address - State:WA
Mailing Address - Zip Code:98047-1413
Mailing Address - Country:US
Mailing Address - Phone:253-638-8730
Mailing Address - Fax:253-735-2584
Practice Address - Street 1:536 BUTTE AVE STE 202
Practice Address - Street 2:
Practice Address - City:PACIFIC
Practice Address - State:WA
Practice Address - Zip Code:98047-1413
Practice Address - Country:US
Practice Address - Phone:253-638-8730
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000055761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAA841319OtherVALUE OPTIONS
WA13223100000OtherPREMERA BLUE CROSS
WASL3994OtherREGENCE BLUESHIELD
WA0001096491OtherMHN
WA0001096491OtherMHN
WA0004465860Medicare UPIN