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CLEANSLATE MEDICAL GROUP OF CONNECTICUT LLC
NPI 1073057071
Internal Medicine - Addiction Medicine in Hartford, CT

Active since December 09, 2016
85 GILLETT ST, HARTFORD, CT 06105(615) 425-0220(413) 727-3619 Get Directions Write a Review

NPPES record last updated: March 23, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 23, 2023, Jul 2, 2019 (2 updates tracked since 2019).

About Cleanslate Medical Group Of Connecticut Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CLEANSLATE MEDICAL GROUP OF CONNECTICUT LLC (NPI 1073057071) is a healthcare organization registered as an addiction medicine in Hartford, Connecticut and active in the NPI registry since December 2016. The organization lists Robert Hutchison, Cfo, as its authorized official.

NPPES Registry Identity

NPI1073057071
Entity TypeOrganization
Primary Taxonomy207RA0401X
Legal Business NameCLEANSLATE MEDICAL GROUP OF CONNECTICUT LLC
Location Address85 GILLETT STHartford, CT 06105-2630
Mailing Address8 Cadillac Dr Ste 180Brentwood, TN 37027-5393 · (615) 425-0220 · Fax (413) 727-3619
Phone(615) 425-0220
Fax(413) 727-3619
Organization SubpartNo
Authorized OfficialRobert HutchisonCfo · (615) 425-0220
Enumeration DateDecember 9, 2016
Last NPPES UpdateMarch 23, 20232 updates tracked since enumeration
NPPES CertifiedMarch 23, 2023
✔ NPI 1073057071 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Addiction MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RA0401X
Definition
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.
Also ListedInternal MedicineTaxonomy 207R00000X
85 GILLETT ST, Hartford, CT 06105
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. UMA TRIVEDI PA
Physician Assistant
85 GILLETT ST
HARTFORD, CT 06105
Capitol Planning Region (860) 969-5554
ASHAM HAMILTON MS, LPC, NCC
Counselor (Professional)
85 GILLETT ST
HARTFORD, CT 06105
Capitol Planning Region (860) 719-0200

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Cleanslate Medical Group Of Connecticut LLC's NPI number?

The NPI number for Cleanslate Medical Group Of Connecticut LLC is 1073057071. It was assigned to this organization in the NPPES registry on December 9, 2016.

Where is Cleanslate Medical Group Of Connecticut LLC located?

Cleanslate Medical Group Of Connecticut LLC is located at 85 Gillett St, Hartford, CT 06105. The listed phone number is (615) 425-0220.

What is Cleanslate Medical Group Of Connecticut LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Addiction Medicine, with taxonomy code 207RA0401X.

When was this NPI record last updated?

The NPPES record for Cleanslate Medical Group Of Connecticut LLC was last updated on March 23, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.