DR. MICHAEL SLACK (NPI# 1245650217) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245650217 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL SLACK |
| Credential | PSY.D |
| Practice Address |
5019 Grove St Ste 102 Marysville WA 98270-4491 |
| Practice Telephone | 3603480205 |
| Enumeration Date | 2014-04-17 |
| Last Update Date | 2014-04-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
LH60412214 | WA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679006076 | Michael Slack | Family Medicine | 5016 N Us Hwy 75, Denison, TX 75020 | 2017-04-04 |
| 1003394495 | Michael Andrew Slack | Physical Therapist | 1712 Owen Dr, Fayetteville, NC 28304-3419 | 2018-07-30 |
| 1588758940 | Michael C Slack | Pediatrics | 22 S Greene St, N5w70c, Baltimore, MD 21201-1544 | 2006-10-02 |
| 1104939222 | Michael Byron Slack | Social Worker | 101 Bodin Cir, David Grant Medical Center, Travis Afb, CA 94535-1809 | 2006-08-15 |
| Street Address |
5019 GROVE ST STE 102 |
| City | MARYSVILLE |
| State | WA |
| Zip Code | 98270-4491 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306075940 | Nicole C Winters | Psychologist | 5019 Grove St Ste 102, Marysville, WA 98270-4491 | 2009-07-02 |
| 1205263597 | Justine V Sanders | Social Worker | 5019 Grove St Ste 102, Marysville, WA 98270-4491 | 2013-10-01 |
| 1841624822 | James William York | Marriage & Family Therapist | 5019 Grove St Ste 102, Marysville, WA 98270-4491 | 2013-08-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730706631 | Amy Jean Tuengel | Massage Therapist | 4731 61st Ne, Marysville, WA 98270 | 2020-06-26 |
| 1821569534 | Andrew M Reid | Physical Therapist | Marysville Physical Therapy, 919 State Avenue Suite 101, Marysville, WA 98270 | 2018-12-07 |
| 1861989162 | Jenna Celine Schmidt | Student in an Organized Health Care Education/Training Program | Seamar Marysville Family Medicine Residency Program, 9710 State Ave, Marysville, WA 98270 | 2018-04-23 |
| 1497103162 | Kyoung Craddock | Registered Nurse | 5722 65th St Ne, Marysville, WA 98270 | 2016-06-02 |
| 1235553348 | Marysville School District | Speech-Language Pathologist | 4220 80th Street Ne, Marysville School District, Marysville, WA 98270 | 2014-02-10 |
| 1386085694 | Malgorzata Cassidy | Counselor | 4308 76th. St. Ne, Marysville, WA 98270 | 2013-07-15 |
| 1972852374 | Suzanne Leboeuf | Counselor | 1227 2nd St., Marysville, WA 98270 | 2012-08-31 |
| 1508121161 | Tricia Nicole Davis | Pharmacy Technician | 6602 74th St Ne, Marysville, WA 98270 | 2012-07-10 |
| 1962774216 | Lynae Marie Swinheart | Community/Behavioral Health | 6418 66th Pl Ne, Marysville, WA 98270 | 2012-02-02 |
| 1598042459 | Jamie Rae Isaacson | Speech-Language Pathologist | 1820 Grove St., Marysville, WA 98270 | 2011-11-07 |
| Find all providers in zip 98270 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336774140 | Darius Deandre Moseley | Counselor | 1502 Buchanan St, Marysville, CA 95901-4629 | 2020-03-12 |
| 1821629577 | Andrea Shively | Counselor | 500 Olive St Ste 18, Marysville, CA 95901-5637 | 2020-01-31 |
| 1033680277 | Elrica Michelle Dy Po | Counselor | 4308 76th St. Ne, Marysville, WA 98270-3720 | 2018-12-16 |
| 1912489402 | Maria Josefa Abella Sloan II | Counselor | 1108 Alder Ave, Marysville, WA 98270-4320 | 2018-08-31 |
| 1144720475 | Deborah Paxton Kukahiko | Counselor | 1720 Grove St, Marysville, WA 98270-4328 | 2018-02-13 |
| 1265962435 | Bryan Eugene Skiles | Counselor | 1106 Columbia Ave Ste 150, Marysville, WA 98270-4347 | 2017-06-19 |
| 1003260225 | Jaime Werner | Counselor | 4412 149th St Ne, Marysville, WA 98271-8976 | 2016-04-14 |
| 1245603117 | Jory Cooper | Counselor | 12601 54th Ave Ne, Marysville, WA 98271-9003 | 2015-11-02 |
| 1104213925 | Wings Enrichment Center | Counselor | 729 S Walnut St, Marysville, OH 43040-1643 | 2015-04-20 |
| 1134516149 | Ring Counseling Services, LLC | Counselor | 1326 5th St, Suite C1a, Marysville, WA 98270-4517 | 2015-04-17 |
| Find all providers in MARYSVILLE | ||||
| City | MARYSVILLE |
| Zip Code | 98270 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.