Slate Clinical Counseling and Consultation LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

SLATE CLINICAL COUNSELING AND CONSULTATION LLC

Practice address

13717 Petrel St
Clarksburg, MD 20871-3403

Phone

(443) 370-9336

NPI assigned

Jul 11, 2023

Last updated

Jul 11, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Maxine Marshall, LCSW-CNPI 1306350467

Title

Ceo/Therapist

Phone

(240) 356-3966

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Maxine Marshall, LCSW-C

  • Clinical Social Worker
  • Clarksburg, MD
  • NPI 1306350467
  NPD Authorized official

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

{
    "created_epoch": "1689033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689033600000",
    "number": "1639857329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13717 PETREL ST",
            "city": "CLARKSBURG",
            "state": "MD",
            "postal_code": "208713403",
            "telephone_number": "443-370-9336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13717 PETREL ST",
            "city": "CLARKSBURG",
            "state": "MD",
            "postal_code": "208713403",
            "telephone_number": "443-370-9336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SLATE CLINICAL COUNSELING AND CONSULTATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-11",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A",
        "authorized_official_last_name": "MARSHALL",
        "authorized_official_first_name": "MAXINE",
        "authorized_official_title_or_position": "CEO/THERAPIST",
        "authorized_official_telephone_number": "240-356-3966",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elena Sanchez
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• Minali Sharma, LCPC
• Simple Balanced Life, LLC
• Whitney Smith
• Sainabou Sosseh
• SSV Medical Group
• Stacie Raltiff, LCSW-C
• Allison Chase Staton, PHARM.D.

• Clinical Social Worker in Clarksburg, MD
• Providers in Clarksburg, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2023; 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.