Individual
BRANDY J SLAVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS, LSW, LCDCIII
Contact information
Practice address
4464 S DIXIE HWY, MIDDLETOWN, OH 45005-5464
(513) 649-8008
(513) 649-8004
Mailing address
4464 S DIXIE HWY, MIDDLETOWN, OH 45005-5464
(513) 649-8008
(513) 649-8004
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCDCIII.81177
OH
101YM0800X
Mental Health Counselor
S.0031905
OH
104100000X
Social Worker
Primary
S.0031905
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0074861
OHIO DEPT. ALCOHOL & DRUG ADDICTION SERVICES
OH
01
—
0074946
OHIO DEPT. MENTAL HEALTH (ODMH) GROUP
OH
01
—
01-0693
CARF CERTIFICATION
OH
01
—
H130910
MEDICARE GROUP PTAN
OH
Enumeration date
05/17/2006
Last updated
02/08/2017
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