CLEANSLATE MEDICAL GROUP OF CALIFORNIA PC (NPI# 1053850388) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053850388 |
| Entity Type | Organization |
| Organization Name | CLEANSLATE MEDICAL GROUP OF CALIFORNIA PC |
| Practice Address |
244 Main St Northampton MA 01060-3886 |
| Practice Telephone | 4135842173 |
| Mailing Telephone | 4135842173 |
| Enumeration Date | 2017-02-20 |
| Last Update Date | 2017-02-20 |
| Authorized Official Name | PATRICK MURPHY (CFO) |
| Authorized Official Telephone | 4135842173 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RA0401X |
Internal Medicine Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
244 MAIN ST |
| City | NORTHAMPTON |
| State | MA |
| Zip Code | 01060-3886 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194264911 | Cleanslate Medical Group of The District of Columbia Pllc | Internal Medicine | 244 Main St, Northampton, MA 01060 | 2017-02-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942869318 | Stephanie Jordan | Counselor | 16 Center St Ste 517, Northampton, MA 01060 | 2019-06-10 |
| 1659853828 | James Drisko | Social Worker | 159 Crescent St, Northampton, MA 01060 | 2018-09-04 |
| 1063994416 | Nancy P Doby | Social Worker | 84 Conz Street, Northampton, MA 01060 | 2018-09-02 |
| 1356821144 | Kathleen Ann Goodwin-boyd | Social Worker | Northampton High School, 380 Elm Street, Northampton, MA 01060 | 2018-08-21 |
| 1457847048 | Kathryn Karusaitis Basham | Social Worker | 155 Main Street C/o Dr. Herzog Phd, Northampton, MA 01060 | 2018-07-06 |
| 1700392289 | Angel Marie Kennedy | Behavioral Analyst | 351 Pleasant St Ste B126, Northampton, MA 01060 | 2017-12-20 |
| 1013437508 | Ricky Jermaine Logan | Counselor | 129 North King Street, Northampton, MA 01060 | 2017-06-26 |
| 1962858886 | Alicia Simoni | Social Worker | 25 Main St Ste 445, Northampton, MA 01060 | 2016-05-10 |
| 1134589708 | James Edmonstone | Clinic/Center | 78 Mainst., Suite 404, Northampton, MA 01060 | 2016-02-25 |
| 1114395639 | Danielle Baker | Speech-Language Pathologist | 228 King St Ste 2, Northampton, MA 01060 | 2015-09-15 |
| Find all providers in zip 01060 | ||||
| Taxonomy Code | 207RA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Addiction Medicine |
| 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. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194264911 | Cleanslate Medical Group of The District of Columbia Pllc | Internal Medicine | 244 Main St, Northampton, MA 01060 | 2017-02-13 |
| 1003195959 | On Call Urgent Care LLC | Internal Medicine | 6 Hatfield St, Northampton, MA 01060-1556 | 2011-08-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154804698 | Bay Medical Systems Associates LLC | Internal Medicine | 29 Main St Ste 101, Millbury, MA 01527-2005 | 2018-09-11 |
| 1619491198 | Willett & Associates | Internal Medicine | 22 Adams St Ste 1, Lynn, MA 01902-2804 | 2017-07-27 |
| 1275897092 | Jeoffrey Michael Hill | Internal Medicine | 100 Stone Manor Dr, New Marlborough, MA 01230-9744 | 2012-06-26 |
| 1487944914 | William Robert Caruso | Internal Medicine | 8 Winthrop Ave, Po 1153, Duxbury, MA 02332-5207 | 2011-04-18 |
| 1417139700 | David Anthony Tortorella | Internal Medicine | 170 Main St Units G4-g8, Tewksbury, MA 01876 | 2007-11-29 |
| 1609920776 | Theodore Treibick | Internal Medicine | 138 East St, Carlisle, MA 01741-1105 | 2007-01-23 |
| 1174544548 | William M Burke | Internal Medicine | 157 Temple St, West Roxbury, MA 02132-3804 | 2006-07-21 |
| 1083633580 | Michael J.f. Iannessa | Internal Medicine | 1233 State Rd, Plymouth, MA 02360-5133 | 2006-07-18 |
| 1235165291 | Robert Barry Downes | Internal Medicine | 169 Pine St, Natick, MA 01760-1332 | 2006-06-23 |
| 1669430526 | Alan A Wartenberg | Internal Medicine | 3 Prince St, Attleboro, MA 02703-1613 | 2006-05-02 |
| Find all providers with the same taxonomy | ||||
| City | NORTHAMPTON |
| Zip Code | 01060 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.