Provider Demographics
NPI:1356430250
Name:SLAUGHTER, TAMEKIA TN (LCSW)
Entity type:Individual
Prefix:MS
First Name:TAMEKIA
Middle Name:TN
Last Name:SLAUGHTER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2720 KIRKBRIDGE DR
Mailing Address - Street 2:BUILDING 800
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14304-5001
Mailing Address - Country:US
Mailing Address - Phone:716-236-2576
Mailing Address - Fax:716-236-2357
Practice Address - Street 1:2720 KIRKBRIDGE DR
Practice Address - Street 2:BUILDING 800
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14304-5001
Practice Address - Country:US
Practice Address - Phone:716-236-2576
Practice Address - Fax:716-236-2357
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY076865-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY066919OtherLMSW
NY076865-1OtherLCSW