Individual provider Active NPI

Patricia Lou Slevin, LSW

  • Counselor
  • Indianapolis, IN
National Provider Identifier
1073026407
Registry record updated Nov 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
33A990 Issued in IN
Practice address
1811 Executive Dr Ste O
Indianapolis, IN 46241-4361
Phone
(317) 627-2568
Fax
(317) 627-2568
NPI assigned
Nov 7, 2017
Last updated
Nov 7, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 33A990 IN Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 33A990 IN

Addresses

Primary practice location

1811 Executive Dr Ste O
Indianapolis, IN 46241-4361

Mailing address

2707 Rand Rd
Indianapolis, IN 46241-5504
Phone (317) 672-2621

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
33A990INMDCounselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1510012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510012800000",
    "number": "1073026407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2707 RAND RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462415504",
            "telephone_number": "317-672-2621",
            "fax_number": "317-866-4065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 EXECUTIVE DR STE O",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462414361",
            "telephone_number": "317-627-2568",
            "fax_number": "317-627-2568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLEVIN",
        "first_name": "PATRICIA",
        "middle_name": "LOU",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-07",
        "last_updated": "2017-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IN",
            "license": "33A990",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IN",
            "license": "33A990",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.