Provider Demographics
NPI:1316170673
Name:SLAUGHTER, JENNIFER BEAZLEY (LCSW, CGP, CDWF)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:BEAZLEY
Last Name:SLAUGHTER
Suffix:
Gender:F
Credentials:LCSW, CGP, CDWF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9311 PORTAL DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77031-2210
Mailing Address - Country:US
Mailing Address - Phone:713-256-3541
Mailing Address - Fax:
Practice Address - Street 1:11211 KATY FWY STE 285
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-2186
Practice Address - Country:US
Practice Address - Phone:713-588-0469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-02
Last Update Date:2017-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX376241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical