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CLEANSLATE CENTERS, LLC
NPI 1629398433
Internal Medicine - Addiction Medicine in West Springfield, MA

Active since June 03, 2010CLIA 22D2076450 · Waiver
82 MAIN ST, WEST SPRINGFIELD, MA 01089(413) 788-0100(413) 736-1813 Get Directions Write a Review

NPPES record last updated: June 9, 2010. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Cleanslate Centers, Llc NPPES

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

CLEANSLATE CENTERS, LLC (NPI 1629398433) is a healthcare organization registered as an addiction medicine in West Springfield, Massachusetts and active in the NPI registry since June 2010. The organization holds a CLIA Waiver certificate valid through August 14, 2027 and lists Amanda L Wilson, Owner, as its authorized official.

NPPES Registry Identity

NPI1629398433
Entity TypeOrganization
Primary Taxonomy207RA0401X
Legal Business NameCLEANSLATE CENTERS, LLC
Location Address82 MAIN STWest Springfield, MA 01089-3942
Mailing AddressPo Box 32Northampton, MA 01061 · (413) 788-0100 · Fax (413) 736-1813
Phone(413) 788-0100
Fax(413) 736-1813
Organization SubpartNo
Authorized OfficialAmanda L WilsonOwner · (413) 788-0100
Enumeration DateJune 3, 2010
Last NPPES UpdateJune 9, 2010
✔ NPI 1629398433 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ 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 ListedCounselor · Mental HealthTaxonomy 101YM0800X
Also ListedPsychologist · Addiction (Substance Use Disorder)Taxonomy 103TA0400X
Also ListedSocial WorkerTaxonomy 104100000X
Also ListedPsychiatry & Neurology · Addiction MedicineTaxonomy 2084A0401X
82 MAIN ST, West Springfield, MA 01089
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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 22D2076450

Cleanslate Centers · West Springfield, MA
Active · expires Aug 14, 2027
CLIA Number22D2076450
Laboratory TypePhysician Office
Certificate Effective DateAugust 15, 2025
Certificate Expiration DateAugust 14, 2027
Laboratory DirectorDr. Khalid Daanish Shaikh
Laboratory Phone(413) 265-2605
Laboratory LocationCleanslate Centers900 Memorial Ave, West Springfield, MA 01089
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

MS. MARY F. CANALE NURSE PRACTITIONER
Nurse Practitioner (Adult Health)
82 MAIN ST
WEST SPRINGFIELD, MA 01089
Hampden County (413) 788-0100
ANGELINA HODGKINS PA-C
Physician Assistant
82 MAIN ST
WEST SPRINGFIELD, MA 01089
Hampden County (413) 788-0100
MS. PRIYANKA SETH PA-C
Physician Assistant
82 MAIN ST
WEST SPRINGFIELD, MA 01089
Hampden County (413) 788-0100

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 Centers, LLC's NPI number?

The NPI number for Cleanslate Centers, LLC is 1629398433. It was assigned to this organization in the NPPES registry on June 3, 2010.

Where is Cleanslate Centers, LLC located?

Cleanslate Centers, LLC is located at 82 Main St, West Springfield, MA 01089. The listed phone number is (413) 788-0100.

What is Cleanslate Centers, LLC's specialty?

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

Does Cleanslate Centers, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 22D2076450) is associated with this NPI, valid through August 14, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Cleanslate Centers, LLC was last updated on June 9, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.