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NPI Profile for CLEANSLATE CENTERS LLC in WEST SPRINGFIELD, MA.
An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Addiction Medicine |
207RA0401X | 11 | Physician/Internal Medicine | |
Addiction (Substance Use Disorder) |
103TA0400X | 62 | Psychologist, Clinical | |
Addiction Medicine |
2084A0401X | 79 | Physician/Addiction Medicine | |
Mental Health |
101YM0800X | |||
Social Worker |
104100000X |
| NPI # | 1629398433 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 06/03/2010 | |
| Last updated | 06/09/2010 - About 16 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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CLEANSLATE CENTERS, LLC