Provider Demographics
NPI:1871704684
Name:SLOCUM, CHRIS (LCSW)
Entity type:Individual
Prefix:MR
First Name:CHRIS
Middle Name:
Last Name:SLOCUM
Suffix:
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 1:1221 W CAMPBELL RD STE 123
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-2900
Mailing Address - Country:US
Mailing Address - Phone:972-231-1211
Mailing Address - Fax:972-231-1279
Practice Address - Street 1:1221 W CAMPBELL RD STE 123
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-2900
Practice Address - Country:US
Practice Address - Phone:972-231-1211
Practice Address - Fax:972-231-1279
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX233491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical