Provider Demographics
NPI:1881050524
Name:SLADE, MEGAN CHRISTINE (LMHC)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:CHRISTINE
Last Name:SLADE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:CHRISTINE
Other - Last Name:VIETZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:4501 15TH AVE S
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98108-1873
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4501 15TH AVE S
Practice Address - Street 2:SUITE 103
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98108-1873
Practice Address - Country:US
Practice Address - Phone:406-425-1198
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-11
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60350001101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health