Provider Demographics
NPI:1487175949
Name:SLAFFEY, HENRIETTA D (LSCSW)
Entity type:Individual
Prefix:MS
First Name:HENRIETTA
Middle Name:D
Last Name:SLAFFEY
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 POYNTZ AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-9979
Mailing Address - Country:US
Mailing Address - Phone:785-226-4403
Mailing Address - Fax:844-318-2492
Practice Address - Street 1:409 POYNTZ AVE STE 105
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-9979
Practice Address - Country:US
Practice Address - Phone:785-730-4550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-05
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS058021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS201164820BMedicaid