Provider Demographics
NPI:1285651901
Name:SLOCUMB, WAYDE ZANE (LPC, NCC)
Entity type:Individual
Prefix:
First Name:WAYDE
Middle Name:ZANE
Last Name:SLOCUMB
Suffix:
Gender:M
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1128 MAHAN DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-1306
Mailing Address - Country:US
Mailing Address - Phone:256-797-6095
Mailing Address - Fax:
Practice Address - Street 1:4800 WHITESPORT CIR SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-6444
Practice Address - Country:US
Practice Address - Phone:256-533-9393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1538101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional