Provider Demographics
NPI:1427109677
Name:SLOAN, JOHN E JR (LCSW)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:E
Last Name:SLOAN
Suffix:JR
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 CONSULTANT PL STE 210
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-6320
Mailing Address - Country:US
Mailing Address - Phone:919-401-4333
Mailing Address - Fax:919-401-4335
Practice Address - Street 1:14 CONSULTANT PL STE 210
Practice Address - Street 2:SUITE A
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-6320
Practice Address - Country:US
Practice Address - Phone:919-401-4333
Practice Address - Fax:919-401-4335
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2014-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0014341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC150T4OtherBCBS
NC6106258Medicaid