Provider Demographics
NPI:1487418158
Name:SLOVIK, JANE A (LCMHCA)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:A
Last Name:SLOVIK
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3427 BETHEL RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28409-9109
Mailing Address - Country:US
Mailing Address - Phone:609-203-4315
Mailing Address - Fax:
Practice Address - Street 1:3427 BETHEL RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28409-9109
Practice Address - Country:US
Practice Address - Phone:609-203-4315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA18525101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty