CLEANSLATE CENTERS LLC NPI 1629398433

NPI Information

  • NPI: 1629398433
  • Provider Name: CLEANSLATE CENTERS, LLC
  • Classification: Internal Medicine - 207RA0401X
  • Specialization: Addiction Medicine
  • Entity Type: Organization
  • Address: 82 MAIN ST
    WEST SPRINGFIELD, MA
    ZIP 01089
  • Phone: (413) 788-0100

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NPI Details

CLEANSLATE CENTERS, LLC is an addiction medicine internal medicine in West Springfield, MA. The provider is 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. CLEANSLATE CENTERS, LLC NPI is 1629398433. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

82 MAIN ST
WEST SPRINGFIELD, MA
ZIP 01089-942
Phone: (413) 788-0100
Fax: (413) 736-1813

The provider's authorized official is Amanda L Wilson .
The authorized official title is Owner and has the following contact phone number (413) 788-0100.

The enumeration date for this NPI number is 6/3/2010 and was last updated on 6/9/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YM0800XCounselorMental HealthNo
2103TA0400XPsychologistAddiction (Substance Use Disorder)No
3104100000XSocial WorkerNo
42084A0401XPsychiatry & NeurologyAddiction MedicineNo
5207RA0401XInternal MedicineAddiction MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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