Provider Demographics
NPI:1184429946
Name:SLATTERY, BENJAMIN (LPC)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:
Last Name:SLATTERY
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:679 S REED CT APT 3-410
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-4478
Mailing Address - Country:US
Mailing Address - Phone:651-260-2462
Mailing Address - Fax:
Practice Address - Street 1:1620 GAYLORD ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-1207
Practice Address - Country:US
Practice Address - Phone:303-338-5894
Practice Address - Fax:303-338-2808
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health