Provider Demographics
NPI:1336274802
Name:SLAGLE, THOMAS SPENCER (LCSW)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:SPENCER
Last Name:SLAGLE
Suffix:
Gender:M
Credentials:LCSW
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 84
Mailing Address - Street 2:
Mailing Address - City:DILLSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28725-0084
Mailing Address - Country:US
Mailing Address - Phone:828-586-2889
Mailing Address - Fax:
Practice Address - Street 1:330 W MAIN ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734-2925
Practice Address - Country:US
Practice Address - Phone:828-627-9254
Practice Address - Fax:828-627-8811
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2009-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0018481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6106004Medicaid