Provider Demographics
NPI:1336305572
Name:SLACIN, KRISTIN MASTER (LPC)
Entity Type:Individual
Prefix:MS
First Name:KRISTIN
Middle Name:MASTER
Last Name:SLACIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8114 COLLINS ST
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-1224
Mailing Address - Country:US
Mailing Address - Phone:703-204-1317
Mailing Address - Fax:
Practice Address - Street 1:133 PARK ST NE
Practice Address - Street 2:THE WOMEN'S CENTER
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-4602
Practice Address - Country:US
Practice Address - Phone:703-281-4928
Practice Address - Fax:703-242-1454
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-06
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004408101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional