Provider Demographics
NPI:1538364328
Name:SLUSHER, JENNIFER JORDAN I (LPC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:JORDAN
Last Name:SLUSHER
Suffix:I
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2727 ELECTRIC RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-3547
Mailing Address - Country:US
Mailing Address - Phone:540-772-5153
Mailing Address - Fax:540-772-5157
Practice Address - Street 1:2727 ELECTRIC RD
Practice Address - Street 2:SUITE 100
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-3547
Practice Address - Country:US
Practice Address - Phone:540-772-5153
Practice Address - Fax:540-772-5157
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAT69747599101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA11754742OtherCAQH