Child & Adolescent Psychological Services, Inc.

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

License

38,965,300 Issued in ND

Legal business name

CHILD & ADOLESCENT PSYCHOLOGICAL SERVICES, INC.

Practice address

1705 4TH Ave NW
Minot, ND 58703-2912

Phone

(701) 839-0474

Fax

(701) 839-0713

NPI assigned

Jul 12, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Stacy Lee Slaughter, PSY.D., LP

Title

Owner/President/Secretary/Treasurer

Phone

(701) 839-0474

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1436659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452729600000",
    "number": "1477937258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 4TH AVE NW",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587032912",
            "telephone_number": "701-839-0474",
            "fax_number": "701-839-0713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 4TH AVE NW",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587032912",
            "telephone_number": "701-839-0474",
            "fax_number": "701-839-0713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILD & ADOLESCENT PSYCHOLOGICAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-12",
        "last_updated": "2016-01-14",
        "status": "A",
        "authorized_official_last_name": "SLAUGHTER",
        "authorized_official_first_name": "STACY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER/PRESIDENT/SECRETARY/TREASURER",
        "authorized_official_telephone_number": "701-839-0474",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D., LP"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "ND",
            "license": "38,965,300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adolescent and Children Mental Health Clinic/Center in Minot, ND
• Providers in Minot, ND by specialty
• Adolescent and Children Mental Health Clinic/Center in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2016; 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.