Provider Demographics
NPI:1548283898
Name:SLAYTON, KENT SHERMAN (LPC)
Entity type:Individual
Prefix:
First Name:KENT
Middle Name:SHERMAN
Last Name:SLAYTON
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19014 LOOKOUT MT. TR.
Mailing Address - Street 2:
Mailing Address - City:HELOTES
Mailing Address - State:TX
Mailing Address - Zip Code:78023
Mailing Address - Country:US
Mailing Address - Phone:210-279-5290
Mailing Address - Fax:
Practice Address - Street 1:8627 CINNAMON CREEK DR
Practice Address - Street 2:SUITE 400
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1480
Practice Address - Country:US
Practice Address - Phone:210-699-0345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12962101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional