Provider Demographics
NPI:1215250915
Name:SLAUGHTER, DALE JEFFERY JR (MA, LPC)
Entity type:Individual
Prefix:MR
First Name:DALE
Middle Name:JEFFERY
Last Name:SLAUGHTER
Suffix:JR
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 FORESTGLADE DRIVE
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27406-6320
Mailing Address - Country:US
Mailing Address - Phone:336-543-7190
Mailing Address - Fax:
Practice Address - Street 1:2 FORESTGLADE DR
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27406-5977
Practice Address - Country:US
Practice Address - Phone:336-593-6688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-09
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7755101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health